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Key Paper Evaluation

New drugs for the treatment of coronary artery syndromes: otamixaban and ticagrelor

Evaluation of: Sabatine MS, Antman EM, Widimsky P et al. Otamixaban for the treatment of patients with non-ST-elevation acute coronary syndromes (SEPIA-AC1 TIMI 42): a randomised, double-blind, active-controlled, Phase 2 trial. Lancet 2009;374:787-795, and Wallentin L, Becker RC, Budaj A et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2009;361:1045-1057.

, PhD DSc
Pages 325-329 | Published online: 21 Jan 2010
 

Abstract

Acute coronary syndromes are a major cause of mortality and morbidity. The objective of this evaluation is to review the clinical trials of two new drugs being developed for the treatment of acute coronary syndromes. The first drug is the anticoagulant otamixaban, and the trial compared otamixaban with unfractionated heparin and eptifibatide in acute coronary syndromes. The second drug is the antiplatelet ticagrelor, and the trial compared ticagrelor with clopidogrel in acute coronary syndromes. In the SEPIA-ACS1 TIMI 42 trial, the primary efficacy endpoint occurred in 6.2% of subjects treated with unfractionated heparin and eptifibatide, and to a significantly lesser extent with otamixaban. In the PLATO trial, the primary efficacy endpoint had occurred less in the ticagrelor group (9.8%) than in the clopidogrel group (11.7%) at 12 months. Two new drugs for acute coronary syndromes, otamixaban and ticagrelor, have recently been shown to have benefits in subjects undergoing percutaneous interventions compared to the present standard regimens for this condition.

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