Ticagrelor is a P2Y12 inhibitor drug used in the prevention of stroke, ischemia, heart attack, and other cardiovascular events in people with the acute coronary syndrome. One of the major concerns with the use of ticagrelor is spontaneous bleeding and bleeding linked with urgent invasive procedures. The effects of ticagrelor may be reversed with a rapid-acting reversal agent. This study aims to evaluate the effect of an antibody-based reversal agent in suppressing the antiplatelet effects of ticagrelor.

This is a randomized, double-blind, placebo-controlled phase-1 trial that included a total of 64 healthy participants. The participants were first given a ticagrelor pretreatment, followed by the administration of PB2452 (a ticagrelor reversal agent) or a placebo after 48 hours. The primary outcome of the study was the platelet function assessed using the transmission aggregometry and platelet-reactivity test.

Out of 64 participants, 48 were assigned to receive PB2452 and 16 to receive a placebo. After 48 hours of receiving PB2452, platelet aggregation was suppressed by 80%. As per multiple assays, PB2452 administration was associated with a greater increase in platelet function than a placebo.

The research concluded that the administration of an antibody-based ticagrelor reversal agent like PB2452 could provide immediate and sustained reversal of the antiplatelet activity of ticagrelor.

Ref: https://www.nejm.org/doi/full/10.1056/NEJMoa1901778