AstraZeneca Drug Beats Plavix for Myocardial Infarction


An experimental anti-clotting drug being developed by AstraZeneca was shown to be more effective than Plavix® (clopidogrel) in treating heart patients who have the most serious type of acute coronary syndrome, those with ST segment elevation myocardial infarction (STEMI). Patients with this condition have a completely obstructed coronary artery that requires emergency surgery.

The new drug developed by AstraZeneca, ticagrelor (proposed brand name Brilinta™), is given to patients to keep their blood platelets from sticking together before and after surgery. In the PLATO study, which was conducted earlier this year, ticagrelor was shown to be superior to Plavix, an FDA-approved drug developed by Bristol-Myers Squibb and Sanofi-Aventis that is currently widely used as an anti-clotting agent.

At the American Heart Association Scientific Sessions in Orlando, Florida, AstraZeneca announced today (November 15) the results of a PLATO sub-analysis in which the researchers looked at patients with STEMI. This patient sub-group included 8,430 patients, which represented 45 percent of the overall PLATO study population of more than 18,000.


In the PLATO STEMI sub-analysis, 4,201 patients received ticagrelor 180 mg loading dose followed by 90 mg twice daily plus aspirin, and 4,229 were given clopidogrel 300 mg loading dose followed by 75 mg daily for 6 to 12 months, plus aspirin.

The sub-analysis showed that, when compared with clopidogrel (Plavix®/Iscover®), ticagrelor resulted in a reduction of cardiovascular events (e.g., heart attack, stroke, cardiovascular death) for up to 12 months (ticagrelor vs. clopidogrel, 9.3% vs. 11.0%). Ticagrelor did not cause an increase in major bleeding (9.0%) when compared with clopidogrel (9.3%). Use of ticagrelor was also associated with an 18 percent reduction in all cause mortality at one year compared with clopidogrel.

Patients who have STEMI need to undergo an emergency procedure known as percutaneous coronary intervention, which restores blood flow, helps save the heart muscle from infarction, and hopefully reduces the chance of death. These patients are at great risk of serious complications and require a fast-acting anti-clotting agent. Ticagrelor was found to act more rapidly than Plavix in the patients with STEMI.

Ticagrelor is the first in a new chemical drug class called CPTPs, or cyclo-pentyl-triazolo-pyrimidines). This drug is chemically different from Plavix and other drugs in its class, known as thienopyridines. If the Food and Drug Administration approves ticagrelor, AstraZeneca has proposed the name Brilinta, and it will compete with Plavix as an anti-clotting drug for treatment of acute coronary syndrome. This syndrome includes ST segment elevation myocardial infarction (STEMI), non-STEMI (partial blockage of coronary artery), and unstable angina.

AstraZeneca news release, November 15, 2009