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PLATO: Aspirin dosage could explain regional discrepancies in ticagrelor efficacy
Mahaffey KW. Circulation. 2011;doi:10.1161/circulationaha.111.047498.
An analysis of the PLATO trial has shown that patients in the United States were much more likely than anywhere else in the world to take a median aspirin dose of at least 300 mg/day, which researchers said may explain a large amount of the regional differences observed with the drug.
The study was initiated after data from the Platelet Inhibition and Patient Outcomes (PLATO) trial indicated that ticagrelor (Brilinta, AstraZeneca) was less effective than clopidogrel (Plavix, Sanofi-Aventis) in North America but not in other parts of the world. AstraZeneca commissioned two statistical groups to independently explore the reason for this discrepancy.
According to study data, far more patients in the United States took a median dose of at least 300 mg/day of aspirin than in the rest of the world (53.6% vs. 1.7%). Although researchers could not exclude play of chance as a possible explanation for these findings, among the 37 factors explored from the PLATO data, only aspirin dose explained a substantial portion of the regional discrepancies.
“Patients with acute coronary syndrome have options to prevent recurrent events. Physicians choosing to use ticagrelor in countries where it is approved and available should consider using a low-dose of maintenance aspirin with the drug,” study researcher Kenneth W. Mahaffey, MD, co-director of CV research at the Duke Clinical Research Institute, Durham, N.C., said in a press release.
Disclosures: Dr. Mahaffey has received consulting fees from AstraZeneca and Sanofi-Aventis and research funding from Sanofi-Aventis. All other study investigators have relevant financial disclosures with one or both of the manufacturers mentioned in this article.
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