Heart drug to cut need for genetic tests

Tests for genetic polymorphisms may no longer be needed before prescribing ACS treatment.

Genes may block drug response (Photograph: spl)
Genes may block drug response (Photograph: spl)

The antiplatelet drug ticagrelor may remove the need for genetic testing of patients, research suggests.

A sub-study of the PLATO trial showed ticagrelor, currently in development, was effective at reducing acute coronary syndromes (ACS) in patients with genetic polymorphisms that cause a poor response to conventional drugs.

The study, published in The Lancet, suggests treatment with ticagrelor means patients could receive faster access to more effective treatment.

At present, ACS is treated using dual antiplatelet therapy in the form of aspirin plus clopidogrel or prasugrel.

However, about 10-15 per cent of patients have genetic variations in the genes CYP2C19 and ABCB1, which can cause a poor response to clopidogrel.

Researchers used data from 10,285 patients who were part of the PLATO trial and agreed to genetic testing.

The primary outcome was a composite of cardiovascular death, MI or stroke, with 12 months follow-up.

Among patients with the genetic polymorphisms, ACS occurred less often with ticagrelor than clopidogrel.

However, in patients without a loss-of-function allele there was no difference in efficacy between the two drugs.

Berkshire GP Dr George Kassianos, a member of the British Cardiovascular Society, said removing the need for genetic profiling was good news, as the service is often unavailable to a practice or the local hospital.

He added: 'It is more versatile when it comes to needing to reverse the anti-thrombotic action. This is important when there is a need to perform an intervention such as a coronary bypass.'

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