NICE Draft Guidance Steers Clinicians Over Ticagrelor Prescription

NICE has issued new guidance regarding the anticoagulant medicine ticagrelor.

Patients who have had a heart attack or stroke should continue to receive the drug for up to three years according to the new guidelines.

And reduced dosage of ticagrelor is also recommended, with NICE Indicating that 60mg alongside aspirin should be considered appropriate.

This new dosage should be implemented for up to three years, following initial treatment to help reduce the risk of heart attacks and strokes.

It is currently normal practice to diagnose a higher 90mg dose alongside aspirin, with a 12-month treatment period usual.

Patients were previously advised to take aspirin alone after this time, after suffering a heart attack.

NICE believes that thousands of patients will benefit from the new recommendations, which comes at a cost of £2 per daily dose.

The healthcare organisation has limited the dosage at three years due to the relatively limited amount of data available on the efficacy of the drug over a longer timeframe.

There are also safety concerns that are yet to be resolved, and thus NICE believes it prudent to limit the period of consumption at three years.

In particular, experts are concerned about how the drug could affect bleeding risk if consumed for longer than a three-year period.

Ticagrelor (Brilique, AstraZeneca) is an oral antagonist of the P2Y12 adenosine diphosphate receptor that inhibits platelet aggregation and thrombus formation.

A 60mg dose costs around £1 per pill, with patients required to consume the medicine orally on a twice-daily basis.

Professor Carole Longson, NICE health technology evaluation centre director, commented on the new guidance, indicating the importance of ensuring that this particular medication is administered correctly.

“Despite the availability of effective secondary prevention treatments as many as a quarter of people who have had a heart attack go on to have another heart attack or stroke – often with devastating consequences.”

Longson continued, outlining that the dangers of ineffective treatment can be both physical and psychological.

“Fear of a recurrence can have a significant negative impact on a person’s quality of life. The evidence shows that ticagrelor, in combination with aspirin, is effective at reducing the risk of further heart attacks and strokes in people who have already had a heart attack. In provisionally recommending ticagrelor we are pleased to be able to increase the treatment options available to the many thousands of people who stand to benefit from it.”

The draft guidance remains open for consultation until 5pm on Monday 5th September.


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