Revacept beneficial to patients with symptomatic ICA stenosis

Patients with symptomatic internal carotid artery (ICA) stenosis may fare well with revacept, a competitive antagonist of glycoprotein VI, as the drug helps reduce the incidence of stroke or death, transient ischaemic attack, and bleeding complications, among others, according to a study.

The study included 160 patients with symptomatic ICA stenosis. They were randomized to receive a single infusion over 20 minutes of 40- or 120-mg revacept in addition to guideline-conforming antiplatelet therapy.

The main clinical outcome was the combined safety and efficacy endpoint, including any stroke or death, transient ischaemic attack, myocardial infarction, coronary intervention, and bleeding complications during follow-up. Researchers also evaluated the number of new ischaemic lesions on diffusion-weighted magnetic resonance imaging after treatment initiation as an exploratory efficacy endpoint.

A total of 158 patients (mean age 68 years, 24 percent female) received the study medication (placebo n=51, revacept 40 mg n=54, 120 mg n=53) and were followed for a mean of 11.2 months.

Compared with placebo, revacept at 120 mg yielded a significant positive effect on the combined safety and efficacy endpoint during follow-up (hazard ratio [HR], 0.46, 95 percent confidence interval [CI], 0.21–0.99; p=0.047). This effect was not observed with the lower 40-mg dose (HR, 0.72, 95 percent CI, 0.37–1.42; p=0.343).

Meanwhile, the incidence of new diffusion-weighted magnetic resonance imaging lesions per patient was comparable across the three treatment groups: 1.16 (95 percent CI, 0.88–1.53) with placebo, 1.05 (95 percent CI, 0.78–1.42) with 40-mg revacept, and 0.63 (95 percent CI, 0.43–0.93) with 120-mg revacept.