AstraZeneca’s antiplatelet drug Brilique can be used alongside aspirin as a long-term maintenance therapy in patients who have had a heart attack, according to NICE.
The UK agency has concluded in draft guidance that giving Brilique (ticagrelor) for a longer period is a cost-effective use of NHS resources and can help prevent further heart attacks or stroke. Brilique costs around £1 per day, according to the agency.
A 90mg dose Brilique given for 12 months after a heart attack is already backed by NICE, but the new draft guidance would allow patients to receive a lower 60mg dose for up to three years. A similar verdict was reached by NICE’s German counterpart IQWiG earlier this year.
The value of longer-term use in heart attack patients was revealed in the PEGASUS trial, which showed Brilinta plus low-dose aspirin was significantly more effective than placebo plus aspirin at reducing the risk of dying from cardiovascular causes, having another heart attack, or having a stroke.
NICE’s health technology evaluation centre director Prof Carole Longson said Brilique that despite the availability of effective secondary prevention treatments, “as many as a quarter of people who have had a heart attack go on to have another heart attack or stroke – often with devastating consequences”.
“Fear of recurrence can have significant negative impact on a person’s quality of life,” she added.
The positive verdict is a boost for AZ, as Brilique (known as Brilinta in the US) is a key growth driver for the company with a sales target of $3.5bn by 2023. In the first half of the year sales rose 48% to reach $395m.
In March the company suffered a setback to its plans after Brilique failed to show efficacy in a stroke trial, with analysts suggesting the $3.5bn target will be tough to achieve without a stroke indication.
The drug remains in development for other new indications however – including peripheral arterial disease and sickle cell disease – and was recently named as a treatment of choice in US guidelines on the treatment of acute coronary syndromes (ACS). It is also in a large-scale trial in patients with coronary artery disease (CAD) and type 2 diabetes.