San Diego, CA (May 7, 2015) — Dr. Roxana Mehran and Dr. C. Michael Gibson discuss Dr. Mehran’s Late-Breaking Clinical Trial, “Ticagrelor versus Clopidogrel in Troponin-negative Patients with Acute Coronary Syndrome Undergoing Ad Hoc Percutaneous Coronary Intervention: Results of a Prospective, Randomized, Multicenter Pharmacodynamic Study”.
Hi mike gibson roxanna marin come into your live from sky 2015 here in san diego first roxanna before we get into your late-breaking trial congratulations on the meeting such energy such participation thank you i really a one-person job it’s an incredible team effort michael jeff bob applegate and the entire sky staff and leadership have been extremely supportive
And i am really excited about sky i mean this is a you know two months after acc we thought nobody would come it’s packed the the whole meeting is filled with case presentations we’re asking all of our clinicians that instead of lecturing to we’re using slides with you know kaplan-meier curves teach that with your cases right so that when people go home they can
Say oh you know what it just showed a case just like that and this is how gibson treated the paper so i think it’s it’s it’s a good thing cage space learning is just such a good way to it really is it really is and we still keep it extremely academic and and of course when it’s anecdotal and someone says well i do it this way we’ll you know there’ll be somebody
On a panel who will correct them and all of this so it’s it’s really exciting about great work so let’s talk a little bit about your late-breaking trial we usually look at pk/pd in patients who are healthy volunteers but then when you go to the real world and say a stemi patient all these drugs have delayed absorption and and all the usual lessons that you learn
In pk/pd studies don’t hold but you’ve got a circled back now to the acs patients who don’t have impaired absorption necessarily who are troponin positive they’re acs and you compared take a girl or any little girl in that ad hoc situation and what did you find so a really great i mean i i got very excited about this study because as you know the treatment
Study did do at hoc pci where they loaded the patients right on the table right whereas in plato it was at first point of contract and there was always this lingering question is takigawa we’re gonna work on the table right and is it gonna have some issues if it were if it’s not done and then so we we had a hundred patients it’s a really small study but really
Meticulous study with a with a lot of excellent sites who did this meticulous work at baseline half an hour two hours at the end of pci whichever came first and then you know again just be eight hours and then just before discharge multiple pr use on those patients after administration for the first time in naive patients include peter girl versus two categories
Were troponin negative acs patients unstable unstable and on and negative because what we wanted to do we didn’t want to have it be muddied by some troponin elevation that might be higher in one group versus the other we wanted a homogeneous population so what we found the primary endpoint was the pru at at two hours and of course it was significant and it was
Significantly better fortunately better for tech egregore but serendipitously because we did these multiple measurements by half an hour within within thirty minutes platelet inhibition was achieved with techical or and i think that really speaks for the fact that this potent agent works fast in acs patients who are not necessarily as you said right sick sick with
The paired gut absorption at conception but this is a this is good news so you would give you could expect the same kinds of outcomes they didn’t get it let’s say in the emergency department so i think that’s a it’s a reassuring study of course there was no this wasn’t at all looking at endpoints and things that although we looked at 30-day endpoints and those are
Not very different but i think it was a very good study for giving yet another level of assurance for physicians who aren’t pre-loading right that they can do it on they want to define the anatomy first or still concerned you can do it no this was this regular oral tech egg or this wasn’t the crushed version not the crushed version and we talked a little bit about
The cross version that yeah apparently now it’s making its way into the label the cross version themselves if you’re treating that level at 30 minutes you may achieve that level even more rapidly with the crushed version yeah we don’t know that i would be interesting but what do you think about the crushed version do you think that the crushed version will have a
Better absorption just i mean it sounds as though i mean looking at the dangerous area higher surface area better penetration you know the in the data that i’m going to show tomorrow night in the symposium and actually does show much higher levels we’re much more rapid and achievement of inhibition with the crushed version wow so it’s being used a fair amount in
Europe and so you know that really begins to bring into question you know some of the parental agents so if you have this very rapid acting crushed version where does that put some of the to b3 inhibitors kangol or and everything you know it’s gonna be very interesting very interesting so the comparator in the future might be the question tackler versus parenteral
Versions of these molecules interesting in the people who don’t have gut edema and impaired peristalsis of course because that’s going to always be a case yes well congratulations thank you and on both the meeting and your late-breaking trial and thanks for joining us here today roxanna and thanks to all of you for joining us here live from sky 2015
Transcribed from video
SCAI 2015: Ticagrelor vs. Clopidogrel in Troponin-Negative Patients By SCAI-TV
