Head-to-head study shows AstraZeneca's Brilinta reduced cardiovascular events compared with Plavix

AstraZeneca presented previously announced Phase III data at the European Society of Cardiology Congress showing that experimental antiplatelet agent Brilinta (ticagrelor) significantly reduced cardiovascular events in patients with acute coronary syndromes (ACS), compared with sanofi-aventis and Bristol-Myers Squibb's Plavix (clopidogrel). Cardiologist Douglas Weaver, a past president of the American College of Cardiology, remarked that Brilinta "will become the new standard of care."

The PLATO trial involved 18 624 patients with ACS. Following 12 months of treatment, 9.8 percent of those given Brilinta experienced cardiovascular events, including cardiovascular death, heart attack or stroke, compared with 11.7 percent in the Plavix group. The company explained that the result was driven by significant reductions in both cardiovascular death and heart attacks, with no difference in strokes. Additionally, the Brilinta group showed a significant 22-percent relative risk reduction in rates of death from any cause, the study found.

In regards to side-effects, AstraZeneca said the findings confirm previous data that showed Brilinta had no increased overall risk of major bleeding compared with Plavix, but noted that there were higher rates of bleeding not related to surgery among patients taking Brilinta.

Commenting on the data, Cleveland Clinic cardiologist Steven Nissen said "the bottom line is, this was a very good result." Weaver noted that AstraZeneca's drug is "more rapid, more effective and it appears to be safer" than Plavix and Eli Lilly and Daiichi Sankyo's Effient (prasugrel), which was recently approved in the US to reduce the risk of blood clots from forming in patients who undergo angioplasty.

Meanwhile, Bristol-Myers Squibb spokesperson Laura Hortas said neither Bristol-Myers Squibb nor sanofi-aventis have reviewed the trial's results yet, but noted that Plavix is approved for use in a wide population with cardiovascular conditions, while the PLATO study focused only on patients with ACS. Michael Leacock, an analyst at Royal Bank of Scotland, said sales projections for Brilinta are $992 million by 2014, but that the forecast is likely to rise based on these findings.

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