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European heart experts on Saturday endorsed the potential use of multiple blood thinning drugs for heart attack patients beyond one year, in a move that may boost demand for AstraZeneca's Brilinta. New European Society of Cardiology (ESC) guidelines state for the first time that use of so-called P2Y12 inhibitors in addition to aspirin beyond one year "may be considered after careful assessment of the ischaemic and bleeding risks of the patient".
The move follows an assessment of two large clinical trials, known as PEGASUS and DAPT, showing that prolonged dual drug treatment can reduce the risk of repeat heart attacks or strokes in patients with previous heart problems. Plavix, which was developed by Sanofi and Bristol-Myers Squibb and is now available as a cheap generic, is the most widely used P2Y12. But Brilinta has shown additional benefits and AstraZeneca is working to ramp up its use.
Following the success of the PEGASUS trial, the British drugmaker is hoping for US Food and Drug Administration approval for extended use of Brilinta as early as next week. Giving Brilinta to patients who had a heart attack over a year ago could more than double the number of people eligible for the medicine. Growing Brilinta is a top priority for AstraZeneca, which has forecast that annual sales of the drug could reach $3.5 billion by 2023. The new ESC guidelines, announced at the organisation's annual meeting in London, also allow for shortened dual drug use of just three to six months, if patients are at high risk of bleeding, as well as extended use up to 30 months.

Copyright Reuters, 2015

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