Ticagrelor has just been approved by the FDA for the prevention of recurrent stroke.

This is an automatically translated article.

The article was written by Pharmacist, Master Nguyen Hoang Phuong Khanh - Clinical Pharmacist - Faculty of Pharmacy, Vinmec Central Park International General Hospital.
Ticagrelor is a drug with antiplatelet effect, circulated in Vietnam under the brand name Brilinta.
In the fourth quarter of 2020, the US Food and Drug Administration (FDA) approved Brilinta to be prescribed for the purpose of reducing the risk of stroke in patients with ischemic stroke (with NISSH score <=5) or high-risk transient ischemic attack.

1. The drug Ticagrelor has just been approved by the FDA for the prevention of stroke recurrence

This approval is based on the THALES phase 3 study, published in The New England Journal of Medicine in January 2020. A double-blind, randomized, controlled study was performed in 11016 patients >= 40 years of age who experienced mild acute stroke or high-risk transient ischemic attack. Patients were divided into 2 groups, group 1 received Ticagrelor 180 mg loading dose on day 1, then 90 mg twice daily in combination with aspirin, group 2 received aspirin and placebo. None of these patients had received thrombolytic therapy or had a thrombectomy within 24 h prior to administration.
In terms of benefits, the study found that the combination of Aspirin and Ticagrelor significantly reduced the rate of stroke and death compared with aspirin alone, by 17% (Absolute risk reduction, 1.1%; HR, 0.83; 95% CI, 0.71 – 0.96; P = 0.015).
Regarding adverse events, the risk of major bleeding complications was approximately 0.5% in the combination group and 0.1% in the aspirin monotherapy group (HR, 3.99; 95% CI, 1.74–9.14; P = 0.001).
This result is also consistent with the rate of occurrence of Ticagrelor side effects announced by the manufacturer. In addition, Ticagrelor may be an alternative for patients with a gene that reduces the function of CYP2C19, leading to a decreased effect of Clopidogrel. In Asia, this proportion is about 40%.

2. Indication of Ticagrelor in Vietnam

Currently in Vietnam, Ticagrelor has not been approved to specify this new update. In the future, it is likely that this designation will be updated.
At Vinmec Central Park, Ticagrelor is approved for the following indications: Concomitant use with Aspirin for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (unstable angina). confirmed, myocardial infarction without ST-segment elevation, myocardial infarction with ST-segment elevation); include patients undergoing medical treatment, patients undergoing percutaneous coronary intervention or coronary bypass surgery.
Ticagrelor drug needs special attention when using, so patients need to be consulted by their doctor/pharmacist about the effects, usage, and side effects before taking the drug.
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Reference sources: NEMJ, FDA, Medscape, Drugbank VN.