A	B	C	D
1	Main
2		Brand Name	Brilinta, fka AZD-6140
3		Generic Name	ticagrelor
4		Mechanism	Reversible P2Y12 receptor antagonist - blocks platelet activation and aggregation, similar to Plavix.
5			Reversibility is relevant as patients have to re-generate platelets before undergoing surgery.
6		Indication	prevention of thrombosis, ACS
7		Administration	oral, BID vs QD for competitors.
8		Competition	Plavix, Prasugrel
9		Market	15-30% of patients on Plavix are non-responders
10		Clinical Studies	greater anti-platelet effects than Plavix, wider therapeutic window?
11
12			PLATO - 1 year Phase III pivotal study - n=18000 - Results ESC 2009
13			9.8% events vs 11.7% for Plavix.
14			Higher dyspnea, minor+major bleeds and no North American site benefit.
15			Higher background rate of aspirin use in US.
16			Brilinta higher bleeds and no efficacy.
17
18			DISPERSE 2 - p2 study of 6140+aspirin vs Plavix+aspirin in ACS
19				n=990 randomized, 90mg/180mg 6140 bid vs Plavix 75mg qd for 12 weeks
20				similar efficacy by MACE, 10.2% bleeding vs 9.2% for Plavix - tendency towards minor bleeds for 6140
21				10% dyspnea vs 6% for Plavix, also uric acid elevations and bradycardia