Ticagrelor

WEDNESDAY, Feb. 19, 2025 -- For patients with acute coronary syndrome (ACS) undergoing drug-eluting stent (DES) implantation, de-escalating dual antiplatelet therapy (DAPT) to P2Y12 inhibitor monotherapy is associated with lower bleeding risk, without an increase in ischemic events, according to a review published online Feb. 18 in the Annals of Internal Medicine . Yong-Joon Lee, M.D., from Severance Hospital at the Yonsei University College of Medicine in Seoul, South Korea, and colleagues compared the effects of de-escalating DAPT to ticagrelor monotherapy versus standard DAPT using data from randomized clinical trials involving patients with ACS. Individual patient data were obtained from three trials, including 9,130 randomized patients with ACS: 3,132 with ST-segment elevation myocardial infarction (STEMI); 3,023 with non-STEMI (NSTEMI); and 2,975 with unstable angina. The researchers found no difference in the rate of the primary ischemic end point (composite of death, nonprocedural [spontaneous] myocardial infarction, or stroke) between the ticagrelor monotherapy and standard DAPT groups (1.7 versus 2.1 percent; hazard ratio, 0.85; 95 percent confidence interval, 0.63 to 1.16). The ticagrelor monotherapy group had a lower rate of the primary bleeding end point (0.8 versus 2.5 percent; hazard ratio, 0.30; 95 percent confidence interval, 0.21 to 0.45). The findings were consistent across STEMI, NSTEMI, and unstable angina. "Our findings suggest that de-escalating DAPT to ticagrelor monotherapy will reduce aspirin-associated major bleeding while preserving the anti-ischemic benefits of antiplatelet therapy for patients with ACS of all types undergoing DES implantation," the authors write.

While drugs are available that reduce levels of a lipoprotein (a), a protein associated with cardiovascular disease, no currently available therapies target this protein directly. Several companies are in various stages of clinical development with drugs that could tackle this protein, and AstraZeneca is paying $100 million to license a preclinical drug gives it a contender in the chase. AstraZeneca’s new cardiovascular asset comes from Hong Kong-based CSPC Pharmaceutical Group. Beyond the upfront payment, the pharmaceutical giant could pay out up to $1.92 billion if the drug achieves development and commercialization milestones, according to deal terms announced Monday. CSPC will also receive royalties from sales of a commercialized product. The CSPC drug, named YS2302018, is in development for dyslipidemia, which is abnormally high levels of cholesterol in the blood. One biological indicator of this condition is high levels of lipoprotein (a), or Lp(a), a type of protein that transports cholesterol through the blood. High Lp(a) levels increase the likelihood of cholesterol buildup in the walls of blood vessels and they are a known risk factor for cardiovascular disease, including coronary artery disease and stroke. presented by Sponsored Post The Promise of Value-Based Care and MedTech Innovation Monica Vajani, Executive Director for mHUB’s MedTech Accelerator, discusses how mHUB is helping innovators transition healthcare towards value-based care. By Monica Vajani - mHUB Lp(a) levels can already be reduced by therapies addressing PCSK9, a liver protein that regulates cholesterol. Studies of the approved PCSK9 inhibitors Repatha from Amgen, and Praluent from Regeneron Pharmaceuticals, showed reductions in Lp(a) levels. Novartis’s approved small interfering RNA (siRNA) therapy Leqvio takes a different approach by silencing the gene that produces PCSK9. That drug also reduces Lp(a). But these therapies do not address Lp(a) directly and they are all administered as injections. AstraZeneca describes CSPC’s YS2302018 as an oral Lp(a) disruptor. Compared to the available injectable therapies addressing PCSK9, the CSPC drug offers the convenience of once-daily oral dosing. That formulation gives AstraZeneca a way to catch up to and potentially compete with Eli Lilly in the treatment of dyslipidemia. Lilly’s muvalaplin is an oral small molecule disrupter of Lp(a) currently in Phase 2 testing. Lilly is also part of a group of companies developing siRNA therapies that reduce Lp(a) levels. The Indianapolis-based pharma giant’s lepodisiran earlier this year began a Phase 3 clinical trial in atherosclerotic cardiovascular disease. Amgen’s olpasiran is in Phase 3 testing in the same indication while Silence Therapeutics’ is preparing to enter pivotal testing with its Lp(a)-reducing drug candidate, zerlasiran. Pelacarsen, an Ionis Pharmaceuticals antisense oligonucleotide intended to reduce Lp(a) production, is in Phase 3 testing under a partnership with Novartis. AstraZeneca’s cardiovascular, renal, and metabolism drug lineup is anchored by the blockbuster products Farxiga (approved for type 2 diabetes, heart failure, and chronic kidney disease) and Brilinta (approved for coronary acute syndromes). The company says the CSPC drug has potential uses in a range of cardiovascular disease indications as a standalone treatment or in combination with other therapies. presented by Health Tech What’s Keeping Healthcare CIOs Up at Night: How to Improve Patient Satisfaction by Handling Calls More Efficiently Health systems have spent billions on portals while investments in modernizing the voice channel — the dominant preference of healthcare consumers — have taken a backseat. By Stephanie Baum One potential combination could pair the CSPC drug with AstraZeneca’s own PCSK9 inhibitor, AZD0780. In May, the pharma giant reported Phase 1 results showing once-daily oral doses of AZD0780 on top of statin therapy led to a statistically significant 52% reduction in levels of LDL cholesterol. The drug was well tolerated and no serious adverse events were reported. AstraZeneca is currently testing the pill in a Phase 2 clinical trial with a targeted enrollment of 428 participants. “Given the scale of unmet need, with cardiovascular disease being a leading cause of death globally, advancing novel therapies that can be used alone or in combination to effectively address known risk factors and advance patient care is particularly important and a key part of our strategy,” Sharon Barr, AstraZeneca executive vice president and head of biopharmaceuticals R&D, said in a prepared statement.