Additional results from the THALES trial have shown that one month's dual antiplatelet therapy with ticagrelor (Brilinta; Astra Zeneca) plus aspirin is associated with a reduction in disabling stroke compared with aspirin alone in patients with minor stroke or high-risk transient ischemic attack (TIA).
Primary results of the THALES trial, published earlier this year in the New England Journal of Medicine (NEJM), showed a reduction in the primary endpoint of stroke or death within 30 days with the combination of ticagrelor plus aspirin versus aspirin alone, although this was accompanied by an increase in bleeding.
In terms of risk/benefit, the main results showed that for every 1000 patients treatment with ticagrelor on top of aspirin would prevent 11 strokes or deaths at the cost of four severe hemorrhages.
The current exploratory analysis, which focuses on the severity of the strokes occurring in the trial, was published online in JAMA Neurology on November 7 to coincide with its presentation at the European Stroke Organisation-World Stroke Organization (ESO-WSO) Conference 2020.
Dr Clay Johnston
Results showed that, compared with aspirin alone, ticagrelor plus aspirin significantly reduced the 30-day risk for disabling stroke or death (4.0% versus 4.7%), and the total disability burden (the shift analysis of the distribution of modified Rankin scale) following subsequent ischemic stroke was reduced by a significant 23%.
