- NEWS . 13 Apr 2020
Efficacy and safety of different ticagrelor regimens vs clopidogrel in CAD patients: the SUPERIOR study
Current guidelines recommend dual antiplatelet therapy with ticagrelor 90 mg twice daily (T90BID) over clopidogrel 75 mg once daily (C75QD) in addition to aspirin for acute coronary syndrome. However, an increased risk of ticagrelor-related adverse events prompted researchers to evaluate the effects of low-dose regimens in a study of 3,043 patients with coronary artery disease (CAD).
The study retrospectively analysed data from 11 hospitals, where the study population received C75QD, T90BID, ticagrelor 45 mg BID (T45BID) or ticagrelor 90 mg QD (T90QD).
Compared with C75QD, both T45BID and T90QD showed significantly higher inhibition of platelet aggregation (p<0.0001) and lower platelet-fibrin clot strength (p<0.0001) induced by adenosine diphosphate. Additionally, the two low-dose regimens had significantly lower minor bleeding rates as well as a significantly larger proportion of patients within the therapeutic window for P2Y12 receptor reactivity. No significant differences were found between T45BID and T90QD in terms of trough plasma concentrations of ticagrelor and its active metabolite. Similar efficacy and safety outcomes were observed in the propensity score-matched analysis.
In summary, low-dose ticagrelor regimens of either T45BID or T90QD appeared to offer a more attractive benefit–risk profile than C75QD or T90BID.
Shi J, et al. Efficacy and safety of different ticagrelor regimens versus clopidogrel in patients with coronary artery disease: a retrospective multicenter study (SUPERIOR). Platelets 2020. doi: 10.1080/09537104.2020.1732328. [Epub ahead of print]