Pooled data from three phase III trials of intravenous cangrelor—presented at the European Society of Cardiology annual congress (ESC; 31 August–4 September, Amsterdam, The Netherkands) and published in The Lancet—show cangrelor demonstrates reductions in angiographic complications compared to oral clopidogrel, confirming the findings of the CHAMPION PHOENIX study (published in April this year).
According to a press release from The Medicines Company, who produce cangrelor, the trials (CHAMPION-PCI, CHAMPION-PLATFORM, and CHAMPION-PHOENIX) compared intravenous cangrelor to either oral clopidogrel or placebo for prevention of thrombotic complications during and after percutaneous coronary intervention (PCI).
The totality of evidence in approximately 25,000 patients undergoing PCI demonstrates that cangrelor significantly reduced the odds of the primary composite endpoint of death, myocardial infarction, ischaemia-driven revascularisation or stent thrombosis at 48 hours after randomisation by 19% (3.8% for cangrelor vs. 4.7% for control; odds ratio 0.81, 95% CI 0.71–0.91, p=0.0007) and stent thrombosis by 41% (0.5% vs. 0.8%, OR 0.59, 95% CI 0.43–0.80, p=0.0008). “The findings were consistent across all analysed subgroups of patients, including age, geography, diagnosis at presentation, and the choice of periprocedural anticoagulant, including more than 5,000 patients treated with bivalirudin,” said CHAMPION programme co-chair Deepak L Bhatt, professor of medicine at Harvard Medical School, chief of cardiology at VA Boston Healthcare System, and senior physician at Brigham and Women’s Hospital.
The pooled analysis also showed that the incidence of clinically important major bleeding as measured by GUSTO and TIMI bleeding scales was not increased with cangrelor. More sensitive measures showed an increase in bleeding with cangrelor, though there was no significant difference in the rate of transfusions. There were significantly more cases of transient dyspnoea with cangrelor than with clopidogrel, a finding that was also observed in the individual CHAMPION studies.