Brilique gains NICE approval
pharmafile | October 31, 2011 | News story | Sales and Marketing | ACS, Brilique, NICE, Plavix, clopidogrel
AstraZeneca’s Brilique has been approved by NICE for use in combination with aspirin as an option to treat patients with acute coronary syndromes (ACS).
Brilique (ticagrelor) is licensed for the treatment of people with ACS who are managed medically or who are to undergo percutaneous coronary intervention (PCI) to widen narrowed arteries in the heart. The drug can be used for up to 12 months.
Brilique competes in the same market as Sanofi/BMS’s Plavix (clopidogrel), which is now available cheaply in generic form in the UK. But despite being much more expensive, NICE recommended Brilique thanks to its superior efficacy in treating ACS compared to clopidogrel.
The guidance was welcomed by Professor Marcus Flather, consultant cardiologist and director of R&D at Norfolk and Norwich University Hospitals NHS Foundation Trust.
He said: “Ticagrelor has been shown to be a more effective treatment option than clopidogrel, and will help us to reduce the rates of repeat heart attack and cardiovascular death in the thousands of patients we treat each year.”
Professor Carole Longson, director of the health technology evaluation centre at NICE, noted that the evidence shows that Brilique, in combination with aspirin, is effective at reducing myocardial infarction and deaths from cardiovascular causes.
AstraZeneca welcomed the guidance, and pointed out that Primary Care Trusts in England and Wales now have three months to ensure that Brilique is available as an option for doctors treating ACS. NICE guidance is also expected to be adopted in Northern Ireland.
Trials of Brilique show it led to a greater reduction in cardiovascular death, a heart attack or stroke – compared with patients who received clopidogrel (9.8% vs. 11.7% at 12 months; 1.9% absolute risk reduction [ARR]; 16% relative risk reduction [RRR]; 95% CI, 0.77 to 0.92; P<0.001).
The difference in treatments was led by cardiovascular death and heart attacks, with no difference in stroke.
Another competitor in the market is Lilly’s Effient (prasugrel), but this was given a more limited approval by NICE in October 2009.
Andrew McConaghie
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