Prospective, Randomized Trial of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome (ISAR-REACT 5)
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ClinicalTrials.gov Identifier: NCT01944800 |
Recruitment Status :
Completed
First Posted : September 18, 2013
Last Update Posted : February 6, 2023
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Condition or disease | Intervention/treatment | Phase |
---|---|---|
Acute Coronary Syndrome (ACS) | Drug: Ticagrelor Drug: Prasugrel | Phase 4 |
Study Type : | Interventional (Clinical Trial) |
Actual Enrollment : | 4018 participants |
Allocation: | Randomized |
Intervention Model: | Parallel Assignment |
Masking: | Single (Outcomes Assessor) |
Primary Purpose: | Treatment |
Official Title: | Prospective, Randomized Trial of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome - Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment (ISAR-REACT) 5 |
Actual Study Start Date : | September 15, 2013 |
Actual Primary Completion Date : | July 2019 |
Actual Study Completion Date : | September 2021 |

Arm | Intervention/treatment |
---|---|
Experimental: Ticagrelor |
Drug: Ticagrelor
Loading dose of 180 mg, followed by maintenance dose of 180 mg per day
Other Name: Brilique |
Active Comparator: Prasugrel |
Drug: Prasugrel
Loading dose of 60 mg, followed by maintenance dose of 10 mg/day or 5 mg/day in patients =/> 75 years or < 60 kg
Other Name: Efient |
- Composite of death, myocardial infarction or stroke [ Time Frame: 12 months ]
- Bleeding [ Time Frame: 12 months ]Bleeding according to BARC
- Mortality [ Time Frame: 12 months ]Death for any cause
- Stroke [ Time Frame: 12 months ]Stroke
- Myocardial Infarction [ Time Frame: 12 months ]
- Stent Thrombosis [ Time Frame: 12 months ]Stent thrombosis according to ARC

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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | No |
Major Inclusion Criteria:
Hospitalization for an acute coronary syndrome (ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction or unstable angina pectoris) with planned invasive strategy
Major Exclusion Criteria:
- intolerance of or allergy to ticagrelor or prasugrel
- history of any stroke, transient ischemic attack or intracranial bleeding
- known intracranial neoplasm, intracranial arteriovenous malformation or intracranial aneurysm
- active bleeding, clinical findings, that in the judgement of the investigator are associated with an increased risk of bleeding
- fibrin-specific fibrinolytic therapy less than 24 h before randomization, non-fibrin-specific fibrinolytic therapy less than 48 h before randomization
- known platelet count < 100.000/μL at the time of screening
- known anemia (hemoglobin <10 g/dL) at the time of screening
- oral anticoagulation that cannot be safely discontinued for the duration of the study
- INR known to be greater than 1.5 at the time of screening
- chronic renal insufficiency requiring dialysis
- moderate or severe hepatic dysfunction (Child Pugh B or C)
- increased risk of bradycardia events (Sick Sinus, AV block grade II or III, bradycardia-induced syncope)
- index event is an acute complication (< 30 days) of PCI
- concomitant medical illness that in the opinion of the investigator is associated with a life expectancy < 1 year
- concomitant oral or i.v. therapy with strong CYP3A Inhibitors (e.g. ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, grapefruit juice > 1 L/d), CYP3A substrates with narrow therapeutic indices (e.g. cyclosporine, quinidine), or strong CYP3A inducers (e.g. rifampin/rifampicin, phenytoin, carbamazepine, dexamethason, phenobarbital ) that cannot be safely discontinued
- ≥1 doses of ticagrelor or prasugrel within 5 days before randomisation
- no written informed consent
- participation in another investigational drug study
- previous enrolment in this study
- for women of childbearing potential no negative pregnancy test and no agree to use reliable method of birth control during the study
- Pregnancy, giving birth within the last 90 days, or lactation
- inability to cooperate with protocol requirements

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01944800

Study Chair: | Adnan Kastrati, MD | Deutsches Herzzentrum München | |
Principal Investigator: | Stefanie Schuepke, MD | Deutsches Herzzentrum München |
Responsible Party: | Deutsches Herzzentrum Muenchen |
ClinicalTrials.gov Identifier: | NCT01944800 |
Other Study ID Numbers: |
GE IDE 00113 2013-002272-40 ( EudraCT Number ) |
First Posted: | September 18, 2013 Key Record Dates |
Last Update Posted: | February 6, 2023 |
Last Verified: | February 2023 |
Ticagrelor Prasugrel Acute coronary syndrome Percutaneous coronary intervention |
Acute Coronary Syndrome Syndrome Disease Pathologic Processes Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases Ticagrelor |
Prasugrel Hydrochloride Platelet Aggregation Inhibitors Purinergic P2Y Receptor Antagonists Purinergic P2 Receptor Antagonists Purinergic Antagonists Purinergic Agents Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Physiological Effects of Drugs |