WILMINGTON, Del., Aug. 29 /PRNewswire-FirstCall/ — A new
genetic substudy of PLATO (A Study of PLATelet Inhibition
and Patient Outcomes) showed that the effects on a combined
primary endpoint of cardiovascular death, myocardial infarction, or
stroke seen in Acute Coronary Syndromes (ACS) patients who received
the investigational oral antiplatelet treatment, ticagrelor
(BRILINTA™), were maintained, whether or not they had the
genetic variability that has been previously shown to affect a
patient’s response to clopidogrel. The substudy is the
first to look at both efficacy and bleeding endpoints of ACS
patients treated with ticagrelor who carry variations in the
CYP2C19 and ABCB1 genes. The data were presented today at the
European Society of Cardiology (ESC) congress in Stockholm, Sweden
and simultaneously published in The Lancet.
Regardless of the CYP2C19 genotype, the primary outcome occurred
less often with ticagrelor versus clopidogrel (interaction p=0.46).
Ticagrelor event rates were 8.6% per year in carriers and
8.8% per year in non-carriers of CYP2C19 loss-of-function genotype.
For clopidogrel patients that carried the CYP2C19 loss-of-function
alleles, there was a 11.2% per year event rate, compared to 10.0%
per year for patients without the loss of function allele. Similar
to the overall PLATO study, total major bleeding did not
significantly differ between ticagrelor and clopidogrel regardless
of CYP2C19 genotype.
The genetic substudy also investigated ticagrelor and
clopidogrel treatment outcomes in the three genetic groupings of
the ABCB1 gene group; these were defined as high, intermediate and
low expressions of ABCB1, respectively. The primary efficacy
event rates for ticagrelor were: 9.5% p