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Plavix Facing New Rival Blood Thinner

Posted by Jane Akre
Monday, August 31, 2009 10:36 AM EST
Category: None
Tags: Heart Attack, Stroke, Atrial Fibrillation, Plavix, AstraZeneca, NEJM

Plavix may be displaced by a new drug, Briilinita, which increases surival from heart attack and stroke in studies.




IMAGE SOURCE: Wikimedia Commons/ box of Plavix/ author: Trounce

Plavix may soon have a rival as an approved blood thinner.

Brilinta, AstraZeneca's clot-fighting experimental drug beat Plavix and warfarin in a study.

Brilinta prevented 16 percent more heart attacks, strokes and deaths than therapy with Plavix, and warfarin or Coumadin, the most widely used drugs, reports Bloomberg.

Plavix, made by Sanofi-Aventis SA and Bristol-Myers, is the second best selling drug with $10 billion in sales annually. If Brilinta acts as expected, it could reduce the risk of early death by 22 percent, according to analysts, without the serious bleeding.

"I think this will become the new standard of care," said Dr. Douglas Weaver, a cardiologist at Henry Ford Hospital in Detroit and a former president of the American College of Cardiology. "It's more rapid, more effective and appears to be safer," he told Bloomberg News.

In this study, called Plato and funded by AstraZeneca, more than 18,000 patients in 43 countries were given Brilinta (also known generically as ticagrelor) or a year after suffering a heart attack or chest pain.

9.8 percent suffered another heart attack or stroke or died, compared with 11.7 percent of those given Plavix. However, fatal bleeding in the brain was slightly more common in those on Brilinta and in the stomach among those who did not undergo bypass surgery.

The results could mean that for every 1,000 patients treated with Brilinta for one year, there would be 14 fewer deaths, reports the Telegraph.

The results were published in the New England Journal of Medicine (NEJM) and were presented this week at the European Society of Cardiology, meeting in Barcelona.

The drugs work by preventing platelets from clumping together to form clots in the heart. The one disadvantage is that it must be taken twice daily, compared to once a day for Plavix.

The U.K. drugmaker will file for approval of Brilinta later this year in Europe and next year in the U.S.

More than a million Americans experience heart attacks and coronary syndromes, with cardiovascular disease the leading cause of death worldwide. Typically, aspirin and Plavix have been used to lower the risk of death.

Warfarin or Coumadin, is a 50-year-old blood thinner derived from rat poison, is used to treat most 2.3 million Americans to treat atrial fibrillation, an erratic heart beat. Use of the drug requires close monitoring of blood levels that is not necessary with Brilinta.

In January, the Food and Drug Administration notified healthcare professionals that Plavix, (clopidogrel bisulfate) is less effective in some patients than others and it will try and determine why.

The difference may be due to genetic factors in the way the body metabolizes clopidogrel. The other possibility to be explored is whether the use of certain other drugs with Plavix interferes with how the body metabolizes it. The news comes after studies found that the blockbuster drug had mixed reviews on effectiveness. #

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