Another blow to this dog of a drug! Let me see, where did I put that $4.00 Plavix Rx? http://www.bidnessetc.com/24927-astrazenecas-brilinta-trials-produce-mixed-results/
No surprise here. The damn drug has been out 3 YEARS!!! AZ needs to realize that this is as good as it gets with Piglinta, and move on. Talking about beating a dead horse!!
Looks like the spin will be on the secondary endpoints. Aren't they the really IMPORTANT ones? Where's the data from a couple of small Eastern European countries when you need em?
I actually think this is a positive review. Reduction in Stent Thrombosis is huge and give Brilinta another advantage over Plavix.
And there you go, reduction in stent thrombosis was a secondary endpoint. See, it's starting already.
Anyone with half a brain could have predicted the outcome of the trial. A STEMI is too far past the point of platelet activation and the hopes of inhibiting the progression of platelet activation are long gone. Administration before hospitalization or during hospitalization matters little with regard to traditional primary endpoints. An ADP inhibitor is not going to dissolve existing clot. Stent thrombosis is as important if not more important than peri-procedural enzyme bumps. An ADP inhibitor administered earlier will prevent future clot from forming. No surprises here. Too many clinical trialists do not understand the historical clinical data. That or they are rolling the dice hoping for a grand slam for the sponsor. Stent thrombosis is more important to operators than marketing has been lead to believe. No surprises there.
Ok...so the bottom line is that it doesn't make any difference. So why would you want to start the drug in the ambulance vs the hospital? What a joke. So watch the spin and the excitement that will try to be created around absolutely nothing!!! Give me a break!!
Gilles Montalescot of the Pitie-Salpetriere Hospital in Paris, who led the study, said there was also an indication that early Brilinta use could cut the risk of stent thrombosis, when blood clots form inside stents that are used to prop open coronary arteries. The stent thrombosis result was statistically significant but it was a secondary finding in an overall neutral study and therefore "should not be interpreted as definitive", he added. On the downside, there was a non-significant excess of deaths in the pre-hospital group, but the total mortality rate in the study was low and it was not clear if this finding meant anything. Let the spin begin.
You wouldn't start in the ambulance. Aortic dissections resemble STEMI. No way to diagnoses without angiogram.
So the non significant excess of deaths will be a total wash, but there will be something to hang a hat on regarding the non definitive reduction in stent thrombosis? Funny how that works isn't it?