BRILIQUE® (ticagrelor)

BRILIQUE (ticagrelor) is the only P2Y12 inhibitor licensed in combination with aspirin to protect patients with prior MI and a high risk* of atherothrombotic events against subsequent CV events in both the acute and long-term treatment settings†1

*High risk is defined as ≥1 additional atherothrombotic risk factor (age ≥65 years, >1 prior MI, multivessel coronary artery disease, diabetes requiring medication, chronic non-end-stage renal dysfunction)1

BRILIQUE (ticagrelor) 90mg twice daily  in combination with  acetylsalicylic acid (ASA) is indicated for patients with Acute Coronary Syndromes (ACS) for up to 12 months. BRILIQUE (ticagrelor) 90mg twice daily is not indicated for use in patients beyond 12 months. There are limited data on the efficacy and safety of BRILIQUE (ticagrelor) 60mg beyond 3 years of extended treatment

Guidelines

BRILIQUE (ticagrelor) is recommended by NICE for patients with ACS6

BRILIQUE (ticagrelor) 90mg twice daily in combination with low-dose aspirin is recommended for up to 12 months as a treatment option in adults with ACS that is, people:

  • with STEMI – defined as ST elevation or new left bundle branch block on electrocardiogram – that cardiologists intend to treat with primary PCI or
  • with NSTEMI or
  • admitted to hospital with unstable angina

BRILIQUE (ticagrelor) is accepted by the Scottish Medicines Consortium for patients with ACS12

Ticagrelor 90mg film-coated tablets (BRILIQUE) are accepted for use within NHS Scotland.

Indication under review: co-administered with aspirin, for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (unstable angina, NSTEMI or STEMI); including patients managed medically, and those who are managed with PCI or CABG.

As dual therapy with aspirin, ticagrelor demonstrated a significant reduction in ischaemic events compared with another antiplatelet drug without significantly increasing the incidence of study-defined major bleeding.

BRILIQUE (ticagrelor) is recommended by European Society of Cardiology in ACS

BRILIQUE (ticagrelor) 90 mg twice daily is recommended in combination with aspirin in patients with ACS regardless of initial treatment strategy, including patients pre-treated with clopidogrel (unless there are contraindications)13

  • In PLATO, 46% of patients received in-hospital clopidogrel prior to randomisation4

BRILIQUE (ticagrelor) is preferred over clopidogrel:

ESC Guidelines
ESC Guidelines

 

a Administration is recommended before or at the latest at the time of the procedure.
b Administration should be considered as soon as the ACS diagnosis is established.
c Unless the bleeding risk outweighs the ischaemic benefit.
Prasugrel is also recommended over clopidogrel in post ACS patients undergoing PCI
NSTE-ACS, non-ST-elevation acute coronary syndrome;

PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction.

BRILIQUE (ticagrelor) 60mg is recommended by NICE for extended treatment10

BRILIQUE (ticagrelor) 60mg is the first and only ADP receptor inhibitor recommended as a treatment option by NICE for extended dual anti-platelettherapy (DAPT)   beyond 1 year for patients with a history of MI at high risk* of atherothrombotic events.

BRILIQUE (ticagrelor) 60mg full indication1

BRILIQUE (ticagrelor) 60mg twice daily, co-administered with ASA, is indicated for the prevention of atherothrombotic events in adult patients with a history of MI of at least one year and a high risk* of developing an atherothrombotic event.

BRILIQUE (ticagrelor) 60mg twice daily may be initiated without interruption as a continuation therapy.

BRILIQUE (ticagrelor) 60mg twice daily may also be initiated up to two years from MI or within one year of stopping previous ADP receptor inhibitor treatment .

There are limited data on the efficacy and safety of BRILIQUE (ticagrelor) 60mg beyond three years of extended treatment.

NICE recommendation10

Ticagrelor, in combination with ASA, is recommended within its marketing authorisation as an option for preventing atherothrombotic events in adults who had an MI and who are at high risk of a further event. 
Treatment should be stopped when clinically indicated or at a maximum of 3 years.

  • Eligible patients now have access to and can benefit from up to 3 years of further risk reduction for atherothrombotic events
  • The NICE committee concluded that the addition of BRILIQUE (ticagrelor) 60mg, in combination with aspirin, may help to reduce the risk of recurrent CV events but that any additional bleeding risk associated with extended treatment should be taken into account when deciding whether to continue antiplatelet treatment in a patient.

NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content on this website.