Ticagrelor recommended by NICE for acute coronary syndromes

Premature discontinuation of antiplatelets in ACS should be avoided | SCIENCE PHOTO LIBRARY

NICE has recommended ticagrelor (Brilique) in combination with low-dose aspirin for up to 12 months as a treatment option for adults with acute coronary syndromes (ACS), ie, STEMI, NSTEMI or unstable angina.

Ticagrelor inhibits platelet aggregation and thrombus formation by acting as a reversible antagonist of the P2Y12 adenosine diphosphate receptor.


Ticagrelor requires a loading dose of 180mg and is subsequently given at a dose of 90mg twice daily for up to 12 months. Patients should also be given a single loading dose of aspirin and continued on an aspirin dose of 75–150mg daily.

Study data

The double-blind, phase 3 PLATO study (n=18,624) compared ticagrelor with clopidogrel, both co-administered with aspirin, over a period of 12 months in patients hospitalised with ACS.

Ticagrelor was significantly more effective than clopidogrel in preventing vascular events in patients with ACS (event rates of 9.8% vs 11.7%; hazard ratio 0.84; 95% CI 0.75–0.95; p<0.001).

There was no significant difference in the rate of major bleeding between the two groups, although more patients taking ticagrelor withdrew from the study because of adverse effects.

NICE — ticagrelor in ACS

Want news like this straight to your inbox?
Sign up for our bulletins

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Already registered?
Sign in

More from MIMS

Pregnant woman having an ultrasound scan with a female sonographer

Valproate prescribing: plan for new regulatory measures without delay, instructs MHRA

A National Patient Safety Alert (NatPSA) has been issued...

Products coming soon - live tracker

EXCLUSIVE TO SUBSCRIBERS Monitor forthcoming UK drug...

New and deleted indications - live tracker

EXCLUSIVE TO SUBSCRIBERS See the latest changes to...

Drug shortages - live tracker

EXCLUSIVE TO SUBSCRIBERS Use our constantly updated...