New data from AstraZeneca’s TWILIGHT trial has found that Brilinta (ticagrelor) on its own reduced the risk of clinically relevant bleeding compared to dual antiplatelet therapy (DAPT) over 12 months in high-risk patients with non-ST elevation acute coronary syndromes (NSTE-ACS).

More specifically, the results of the subgroup analysis showed that the monotherapy was associated with a 53% relative reduction in the risk of the primary endpoint over one year, with an absolute risk reduction of 4.0%, compared to ticagrelor with aspirin.

A secondary endpoint of the subgroup analysis also showed similar rates of the composite of all-cause death, myocardial infarction or stroke between monotherapy and DAPT.

The trial also saw a  reduction in the risk of BARC 3 or 5 bleeding in patients treated with monotherapy, compared to the drug plus aspirin over one year.

“The TWILIGHT trial provided important information about the longer-term management of high-risk patients who had undergone PCI” explained Danilo Verge, vice president global medical affairs, cardiovascular, renal and metabolism.

He continued, “In this pre-specified subgroup analysis of patients with NSTE-ACS enrolled in TWILIGHT, treatment with ticagrelor monotherapy, without aspirin, after three months of DAPT was associated with a lower risk of bleeding compared with standard 12 months of dual antiplatelet therapy with ticagrelor plus aspirin.”

The drug in question is an oral, reversible, direct-acting P2Y12 receptor antagonist that works by inhibiting platelet activation. It has previously been shown to significantly reduce the risk of major adverse cardiovascular (CV) events in patients with acute coronary syndrome (ACS) or a history of myocardial infarction (MI).

Co-administered with aspirin, it is indicated for the prevention of atherothrombotic events in adult patients with ACS, or for patients with a history of MI and a high risk of developing an atherothrombotic event.