A newer alternative to clopidogrel for acute coronary syndromes, taken directly rather than needing an enzyme to switch it on. Genetics moves its blood levels a measurable amount — and, unlike clopidogrel, that movement has not been shown to change how well it works.
Solid lines are connections this site curates. Dashed lines mean the two ends share a research paper — worth knowing, and not a claim that one explains the other.
Ticagrelor is a P2Y12 inhibitor prescribed alongside clopidogrel for acute coronary syndromes. In a genome-wide study within the PLATO trial (discovery and replication cohorts totalling 3,753 patients), a variant in SLCO1B1 predicted both ticagrelor and its main metabolite's plasma levels. The same gene, through the same transporter, is the one behind this site's statin muscle-symptom finding — one transporter, two different drugs. Despite the statistical association, the study's own conclusion is that these genetic effects on drug levels were modest and did not detectably change efficacy or safety in the 4,990 patients whose clinical outcomes were analysed. A measurable pharmacokinetic effect that does not reach clinical significance — reported here for what it is rather than what it might imply.
Varenhorst C et al., European Heart Journal 2015 — genetic variation and ticagrelor plasma levels and clinical outcomes in the PLATO trial. PMID:25935875
The same PLATO-trial study found a second, independent signal for ticagrelor plasma levels in the CYP3A4/CYP3A5 gene region — genes that metabolise a large share of prescription drugs generally. As with the SLCO1B1 finding on this page, the effect on drug levels was real but modest, and the study found no detectable downstream effect on how well ticagrelor worked or how safe it was.
Varenhorst C et al., European Heart Journal 2015 — genetic variation and ticagrelor plasma levels and clinical outcomes in the PLATO trial. PMID:25935875
Every guideline above was written by people. Named here because they are contributors to this page in the same sense anybody else on this site is.
These are the positions in your own file that carry the genes above. Not every gene in a guideline is one we report — where that is the case the gene appears above without a variant here, and the note says so.
SLCO1B1 · rs4149081
Read more →SLCO1B1 · rs11045879
Read more →SLCO1B1 · rs4149056
Read more →SLCO1B1 · rs2900478
Read more →SLCO1B1 · rs73079476
Read more →SLCO1B1 · rs11045856
Read more →SLCO1B1 · rs4149083
Read more →Ticagrelor is a P2Y12 inhibitor prescribed alongside clopidogrel for acute coronary syndromes, taken directly rather than needing an enzyme to switch it on. Genetics moves its blood levels a measurable amount, though that hasn’t been shown to change how well it works.
No. A study within the PLATO trial (3,753 patients) found this SLCO1B1 variant predicted ticagrelor blood levels, but among the 4,990 patients whose outcomes were analysed, the effect was modest and did not detectably change how well the drug worked or how safe it was.
Yes — same gene, same transporter (OATP1B1), two completely different drugs, though the consequence isn’t the same in each case.
Yes. The same PLATO study found a second, independent signal for ticagrelor blood levels in the CYP3A4/CYP3A5 region. As with SLCO1B1, the effect on drug levels was real but modest, with no detectable effect on efficacy or safety.