AstraZeneca’s P2Y12 receptor antagonist Brilinta reduced the rate of stroke and death in a prespecified, high-risk subgroup, according to new analysis of the phase III THALES trial.

The prespecified subgroup contained patients who had an acute ischaemic stroke or a transient ischaemic attack (TIA) and had ipsilateral atherosclerotic stenosis in the head and neck (cervicocranial) arteries.

In this group, Brilinta (ticagrelor) taken twice daily alongside daily aspirin reduced the rate of the composite of stroke and death by 27% compared to aspirin alone.

In another subgroup of patients – without ipsilateral stenosis at baseline – the rate of the primary composite endpoint of stroke or death was 4.8% for the Brilinta plus aspirin treated patients, compared to 5.3% in the aspirin alone group.

Brilinta plus aspirin also reduced the rate of the first secondary endpoint of ischaemic stroke by 28% compared to aspirin alone up to day 30 in this subgroup.

“Patients who had an acute ischaemic stroke or a transient ischaemic attack are at high risk for recurrent, potentially disabling or fatal events,” said Mene Pangalos, executive vice president, BioPharmaceuticals R&D, AZ.

“Given this and the established heritage of ticagrelor in the prevention of atherothrombotic events, we are pleased to see that aspirin plus ticagrelor has the potential to be an effective preventive treatment for subsequent stroke in patients with cervicocranial atherosclerosis,” he added.

Earlier this month, the US Food and Drug Administration (FDA) approved Brilinta to reduce the risk of stroke in patients with acute ischaemic stroke or high-risk TIA.