Dr John Eikelboom Compares the COMPASS Trial to EUCLID and PEGASUS

Compared with the trial results of EUCLID and PEGASUS, the COMPASS trial advances the field of cardiovascular disease in combination therapies, said John Eikelboom, MD, of McMaster University.

Transcript (slightly modified)

Can you put the results of the COMPASS trial in perspective compared with the results of the EUCLID and PEGASUS trials?

The recent trials EUCLID and PEGASUS attempted to improve on the existing standard of care by evaluating alternative, more intensive, antithrombotic strategies. If we take EUCLID, this was a trial in patients with peripheral artery disease that evaluated ticagrelor as an alternative to clopidogrel. The EUCLID trial was very important, very large, a well-done study and it showed absolutely no benefit of ticagrelor. Thus, the EUCLID trial didn’t really advance treatment in peripheral artery disease.

The PEGASUS trial was an important, and, again, global, large, well-done study in patients post-myocardial infarction. In this trial, 2 doses of ticagrelor that were tested were on top of aspirin and the results indicate a reduction in major adverse cardiovascular events, an increase in bleeding, and no overall mortality benefit. So, in this context, the results of COMPASS really advanced the field because the combination therapy in COMPASS doesn’t only reduce major adverse cardiovascular events, but also reduces total mortality.