BRILIQUE 90 MG ( TICAGRELOR ) 56 FILM-COATED TABLETS

Brilque Guidelines
BRILIQUE (ticagrelor) is recommended by NICE for patients with ACS6
BRILIQUE (ticagrelor) 90mg twice daily in combination with low-dose aspirin is recommended for up to 12 months as a treatment option in adults with ACS that is, people:

with STEMI – defined as ST elevation or new left bundle branch block on electrocardiogram – that cardiologists intend to treat with primary PCI or
with NSTEMI or
admitted to hospital with unstable angina
BRILIQUE (ticagrelor) is accepted by the Scottish Medicines Consortium for patients with ACS12
Ticagrelor 90mg film-coated tablets (BRILIQUE) are accepted for use within NHS Scotland.

Indication under review: co-administered with aspirin, for the prevention of atherothrombotic events in adult patients with acute coronary syndromes (unstable angina, NSTEMI or STEMI); including patients managed medically, and those who are managed with PCI or CABG.
As dual therapy with aspirin, ticagrelor demonstrated a significant reduction in ischaemic events compared with another antiplatelet drug without significantly increasing the incidence of study-defined major bleeding.

BRILIQUE (ticagrelor) is recommended by European Society of Cardiology in ACS
BRILIQUE (ticagrelor) 90 mg twice daily is recommended in combination with aspirin in patients with ACS regardless of initial treatment strategy, including patients pre-treated with clopidogrel (unless there are contraindications)13

In PLATO, 46% of patients received in-hospital clopidogrel prior to randomisation4
BRILIQUE (ticagrelor) is preferred over clopidogrel:

ESC Guidelines
 

a Administration is recommended before or at the latest at the time of the procedure.
b Administration should be considered as soon as the ACS diagnosis is established.
c Unless the bleeding risk outweighs the ischaemic benefit.
Prasugrel is also recommended over clopidogrel in post ACS patients undergoing PCI
NSTE-ACS, non-ST-elevation acute coronary syndrome;

PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction.

BRILIQUE (ticagrelor) 60mg is recommended by NICE for extended treatment10
BRILIQUE (ticagrelor) 60mg is the first and only ADP receptor inhibitor recommended as a treatment option by NICE for extended dual anti-platelettherapy (DAPT)   beyond 1 year for patients with a history of MI at high risk* of atherothrombotic events.

BRILIQUE (ticagrelor) 60mg full indication1
BRILIQUE (ticagrelor) 60mg twice daily, co-administered with ASA, is indicated for the prevention of atherothrombotic events in adult patients with a history of MI of at least one year and a high risk* of developing an atherothrombotic event.

BRILIQUE (ticagrelor) 60mg twice daily may be initiated without interruption as a continuation therapy.

BRILIQUE (ticagrelor) 60mg twice daily may also be initiated up to two years from MI or within one year of stopping previous ADP receptor inhibitor treatment .

There are limited data on the efficacy and safety of BRILIQUE (ticagrelor) 60mg beyond three years of extended treatment.

NICE recommendation10
Ticagrelor, in combination with ASA, is recommended within its marketing authorisation as an option for preventing atherothrombotic events in adults who had an MI and who are at high risk of a further event. 
Treatment should be stopped when clinically indicated or at a maximum of 3 years.
Eligible patients now have access to and can benefit from up to 3 years of further risk reduction for atherothrombotic events
The NICE committee concluded that the addition of BRILIQUE (ticagrelor) 60mg, in combination with aspirin, may help to reduce the risk of recurrent CV events but that any additional bleeding risk associated with extended treatment should be taken into account when deciding whether to continue antiplatelet treatment in a patient.

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