Response and effectiveness

Brilinta is more effective than clopidogrel (Plavix). A 180mg loading dose of Brilinta inhibited 41% of platelets in 30 minutes. Clopidogrel 600mg takes nearly 8 hours to achieve the same effect.

Brilinta achieved maximum platelet inhibition (88% inhibition) two hours after administration. Crushing and administering tablets appears to shorten the time to peak concentrations. Platelet inhibition is at its peak for another six hours (eight hours total). Platelet inhibition is still 58% 24 hours after a Brilinta dose. Platelet inhibition drops to 56% after 56 hours (over 2 days) and 10% after 110 hours (over 4 days).

After a stent or heart attack, Brilinta is typically used for 6 to 12 months, or longer. To help prevent blood clots, it is administered along with low-dose aspirin. Brilinta may be administered for varying lengths of time, depending on the use.

Studies have shown that Brilinta is superior to the use of clopidogrel, another antiplatelet medication, for at least one year following ACS (Plavix).

At 36 months, aspirin plus Brilinta 60 mg was found to be significantly more effective at preventing a major event like a heart attack or stroke in studies of high-risk patients with coronary artery disease (CAD) and type-2 diabetes than aspirin alone.

In studies, patients who experienced a TIA or acute ischemic stroke within 24 hours of onset received Brilinta or a placebo. The average duration of the treatment was 30 days. Brilinta was found to reduce the rate of a composite of stroke and death more effectively than the placebo (the primary endpoint). The manufacturer advises continuing treatment for up to 30 days. Early on in the therapy process, the treatment effect began to accumulate.

Depending on the intended use, Brilinta may be administered in the first dose as a loading dose, which is a higher dose intended to help the body reach therapeutic levels more quickly. Within 30 minutes of taking this loading dose, Brilinta typically begins to inhibit platelets, according to data from the manufacturer (two 90 mg tablets). However, a small, open-label study found that in patients receiving a stent and having received a loading dose of Brilinta, it can take anywhere between 2 and 11 hours to achieve adequate platelet inhibition.

Responses can vary from patient to patient, and some patients who are having a stent implanted after a heart attack may require additional antiplatelet therapy to prevent stent thrombosis.

Brilinta appears to be more effective than Plavix at lowering the risk of CV death, MI, or stroke in the first year of treatment, according to PLATO clinical trial data.