In final guidance, the National Institute for Health and Clinical Excellence (NICE) has recommended the use of AstraZeneca's "clotbuster" Brilique (ticagrelor), in combination with aspirin and for up to 12 months, as an option to treat adults with acute coronary syndromes (ACS).

Every year around 200,000 people in England are diagnosed with ACS, among whom around three-quarters have unstable angina or non-ST-segment-elevation myocardial infarction (NSTEMI) - the latter occurs when ischaemia (blockage by a blood clot of one of the large blood vessels carrying blood to the heart) results in damage to the heart muscle.

Brilique is an anti-platelet drug which 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.

NICE's newly-released final guidance recommends its use, in combination with aspirin, as a treatment option in people with ST-segment-elevation myocardial infarction (STEMI) who are to undergo PCI, and also in people with NSTEMI. It is further recommended as a treatment option for people admitted to hospital with unstable angina.

The guidance was welcomed by Professor Marcus Flather, consultant cardiologist and director of R&D at Norfolk and Norwich University Hospitals NHS Foundation Trust, who said that Brilique "has been shown to be a more effective treatment option than clopidogrel [Bristol-Myers Squibb/Sanofi's Plavix] and will help us 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.

In recommending the drug's use where clinically appropriate, the new guidance "is an affirmation of that effectiveness and good news for patients with ACS, wherever they live in England and Wales, because it increases the number of treatment options available to them," Prof Longson added.

Also welcoming the recommendation, AstraZeneca pointed out that Primary Care Trusts (PCTs) in England and Wales now have three months to ensure that Brilique is made available as an option for physicians to use in the treatment of ACS. The NICE guidance is also expected to be adopted in Northern Ireland, the firm added.

Ticagrelor has now been approved in 43 countries, including the European Union (EU) under the trade name Brilique and in the US, Canada and Brazil under the trade name Brilinta. The product currently has price approvals in 19 countries and reimbursement authorisations in nine, says AstraZeneca.