PROVEN SUPERIOR TO
CLOPIDOGREL IN REDUCING
CV DEATH AT 12 MONTHS
CV death secondary end point: RRR with BRILINTA plus aspirin
was 21% (ARR 1.1%) vs clopidogrel plus aspirin§1
HELP MAKE
AN IMPACT
WITH
BRILINTA
INDICATIONS
BRILINTA is indicated to reduce the rate of thrombotic
cardiovascular (CV) events in patients with acute coronary syndrome
(ACS) (unstable angina, non–ST-elevation myocardial infarction,
or ST-elevation myocardial infarction). BRILINTA has been shown
to reduce the rate of a combined end point of CV death, myocardial
infarction (MI), or stroke compared to clopidogrel. The difference
between treatments was driven by CV death and MI with no difference
in stroke. In patients treated with PCI, it also reduces the rate of
stent thrombosis.
BRILINTA has been studied in ACS in combination with aspirin.
Maintenance doses of aspirin >100 mg decreased the effectiveness
of BRILINTA. Avoid maintenance doses of aspirin >100 mg daily.
BLEEDING AT 12 MONTHS, there was no significant
difference in Total Major Bleeding (which includes Fatal
and Life-threatening bleeding) for BRILINTA plus aspirin
vs clopidogrel plus aspirin (11.6% vs 11.2%).
There was a somewhat greater risk of Non–CABG-related
Major plus Minor Bleeding for BRILINTA plus aspirin vs
clopidogrel plus aspirin (8.7% vs 7.0%) and Non–CABGrelated Major Bleeding (4.5% vs 3.8%), respectively.
PLATO trial did not show an advantage for BRILINTA
compared with clopidogrel for CABG-related Bleeding
(Total Major 85.8% vs 86.9% and Fatal/Life-threatening
48.1% vs 47.9%, respectively). 1
*Excluding silent MI. †RRR=relative risk reduction. ‡ARR=absolute risk reduction.
§
The PLATO study compared BRILINTA (180-mg loading dose, 90 mg twice daily
thereafter) and clopidogrel (300-mg to 600-mg loading dose, 75 mg daily thereafter)
for the prevention of CV events in 18,624 patients with ACS (UA, NSTEMI, STEMI).
Patients were treated for at least 6 months and up to 12 months. BRILINTA and
clopidogrel were studied with aspirin and other standard therapies.
WARNINGS AND PRECAUTIONS
• Moderate Hepatic Impairment: Consider the risks and
benefits of treatment, noting the probable increase in
exposure to ticagrelor
• Premature discontinuation increases the risk of MI, stent
thrombosis, and death
• Dyspnea was reported in 14% of patients treated with
BRILINTA and in 8% of patients taking clopidogrel.
Dyspnea resulting from BRILINTA is self-limiting. Rule out
other causes
• BRILINTA is metabolized by CYP3A4/5. Avoid use with
strong CYP3A inhibitors and potent CYP3A inducers. Avoid
simvastatin and lovastatin doses >40 mg
• Monitor digoxin levels with initiatio