The National Institute for Health and Clinical Excellence (NICE) has issued final draft guidance recommending the use of AstraZeneca's antiplatelet drug Brilique (ticagrelor) in the treatment of acute coronary syndromes (ACS).

Every year, around 200,000 people in England are diagnosed with ACS, which cover a range of conditions from unstable angina to myocardial infarction (MI). NICE's draft guidance for Brilique recommends its use, in combination with aspirin, as a treatment option in people with ST-segment-elevation myocardial infarction (STEMI) who are to undergo primary percutaneous coronary intervention (PCI) and in people with non-ST-segment-elevation myocardial infarction (NSTEMI).

NICE also recommends Brilique as a treatment option for people with unstable angina.

Mortality from MI and other cardiovascular causes has declined in recent years, but an increasingly ageing population, coupled with worrying trends in the incidence of obesity and lifestyles that involve less exercise, make the management of ACS a continuing high priority, commented Professor Carole Longson, director of the health technology evaluation centre at NICE.

The Institute's independent appraisal committee concluded from the evidence that Brilique plus aspirin significantly reduces MI and death from cardiovascular disease, by 16% and 21% respectively, compared with Sanofi/Bristol-Myers Squibb's Plavix (clopidogrel) plus aspirin, she noted, and added that the draft guidance recognises the potential of Brilique "in providing the NHS in England and Wales with another valuable tool to enable it it deal more effectively with the long-term management of ACS."

The draft guidance has been welcomed by Kausik Ray, professor of cardiovascular disease prevention at St George's Hospital NHS Trust Research Centre, who called it a "significant step forward for patients and doctors alike" which will "hopefully have a positive effect on many patients with ACS treated by the NHS."

The total cost of the management of heart attacks and unstable angina in the UK is around £1.5 billion a year, says AstraZeneca.

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