Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome

Elmir Omerovic; David Erlinge; Sasha Koul; Ole Frobert; Jonas Andersson; Johan Ponten; Fredrik Björklund; Robert Kastberg; Max Petzold; Charlotta Ljungman; Kristian Bolin; Björn Redfors

doi:10.1016/j.ahj.2022.05.017

Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome

Elmir Omerovic, David Erlinge, Sasha Koul, Ole Frobert, Jonas Andersson, Johan Ponten, Fredrik Björklund, Robert Kastberg, Max Petzold, Charlotta Ljungman, Kristian Bolin, Björn Redfors^*

^*Corresponding author for this work

Department of Clinical Medicine

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

11 Citations (Scopus)

Abstract

Background: European treatment guidelines recommend prasugrel over ticagrelor for treating patients with non–ST-elevation acute coronary syndrome (ACS), prompting several Swedish administrative regions to transition from ticagrelor to prasugrel as the preferred treatment for patients with ACS. We aim to systematically evaluate this transition to determine the relative efficacy of prasugrel versus ticagrelor in a real-world cohort of patients with ACS. Study design and objectives: The SWITCH SWEDEHEART trial is a prospective, multicenter, open-label, cross-sectional, stepped-wedge cluster-randomized clinical trial, in which administrative regions in Sweden will constitute the clusters. At the start of the study, all clusters will use ticagrelor as the P2Y12 inhibitor drug of choice for ACS. The order in which the clusters will implement the transition from ticagrelor to prasugrel will be randomly assigned. Every 9 months, 1 cluster will switch from ticagrelor to prasugrel as the P2Y12 inhibitor of choice for patients with ACS. The primary endpoint is the composite 1-year rate of the death, stroke, or myocardial infarction. Conclusions: The SWITCH SWEDEHEART study will provide an extensive randomized comparison between ticagrelor and prasugrel. Novel therapies are frequently costly and supported by evidence from few or small studies, and systematic evaluation after the introduction is rare. This study will establish an important standard for introducing and evaluating the effects of health care changes within our societies.

Original language	English
Journal	American Heart Journal
Volume	251
Pages (from-to)	70-77
Number of pages	8
ISSN	0002-8703
DOIs	https://doi.org/10.1016/j.ahj.2022.05.017
Publication status	Published - Sept 2022

Access to Document

10.1016/j.ahj.2022.05.017

Fingerprint

Dive into the research topics of 'Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome'. Together they form a unique fingerprint.

Cite this

Omerovic, E., Erlinge, D., Koul, S., Frobert, O., Andersson, J., Ponten, J., Björklund, F., Kastberg, R., Petzold, M., Ljungman, C., Bolin, K., & Redfors, B. (2022). Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome. American Heart Journal, 251, 70-77. https://doi.org/10.1016/j.ahj.2022.05.017

@article{72d43224d1dd409b86d9ca725cca467b,

title = "Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome",

abstract = "Background: European treatment guidelines recommend prasugrel over ticagrelor for treating patients with non–ST-elevation acute coronary syndrome (ACS), prompting several Swedish administrative regions to transition from ticagrelor to prasugrel as the preferred treatment for patients with ACS. We aim to systematically evaluate this transition to determine the relative efficacy of prasugrel versus ticagrelor in a real-world cohort of patients with ACS. Study design and objectives: The SWITCH SWEDEHEART trial is a prospective, multicenter, open-label, cross-sectional, stepped-wedge cluster-randomized clinical trial, in which administrative regions in Sweden will constitute the clusters. At the start of the study, all clusters will use ticagrelor as the P2Y12 inhibitor drug of choice for ACS. The order in which the clusters will implement the transition from ticagrelor to prasugrel will be randomly assigned. Every 9 months, 1 cluster will switch from ticagrelor to prasugrel as the P2Y12 inhibitor of choice for patients with ACS. The primary endpoint is the composite 1-year rate of the death, stroke, or myocardial infarction. Conclusions: The SWITCH SWEDEHEART study will provide an extensive randomized comparison between ticagrelor and prasugrel. Novel therapies are frequently costly and supported by evidence from few or small studies, and systematic evaluation after the introduction is rare. This study will establish an important standard for introducing and evaluating the effects of health care changes within our societies.",

author = "Elmir Omerovic and David Erlinge and Sasha Koul and Ole Frobert and Jonas Andersson and Johan Ponten and Fredrik Bj{\"o}rklund and Robert Kastberg and Max Petzold and Charlotta Ljungman and Kristian Bolin and Bj{\"o}rn Redfors",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2022",

month = sep,

doi = "10.1016/j.ahj.2022.05.017",

language = "English",

volume = "251",

pages = "70--77",

journal = "American Heart Journal",

issn = "0002-8703",

publisher = "Elsevier Inc.",

}

Omerovic, E, Erlinge, D, Koul, S, Frobert, O, Andersson, J, Ponten, J, Björklund, F, Kastberg, R, Petzold, M, Ljungman, C, Bolin, K & Redfors, B 2022, 'Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome', American Heart Journal, vol. 251, pp. 70-77. https://doi.org/10.1016/j.ahj.2022.05.017

Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome. / Omerovic, Elmir; Erlinge, David; Koul, Sasha et al.
In: American Heart Journal, Vol. 251, 09.2022, p. 70-77.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Rationale and design of switch Swedeheart

T2 - A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome

AU - Omerovic, Elmir

AU - Erlinge, David

AU - Koul, Sasha

AU - Frobert, Ole

AU - Andersson, Jonas

AU - Ponten, Johan

AU - Björklund, Fredrik

AU - Kastberg, Robert

AU - Petzold, Max

AU - Ljungman, Charlotta

AU - Bolin, Kristian

AU - Redfors, Björn

PY - 2022/9

Y1 - 2022/9

N2 - Background: European treatment guidelines recommend prasugrel over ticagrelor for treating patients with non–ST-elevation acute coronary syndrome (ACS), prompting several Swedish administrative regions to transition from ticagrelor to prasugrel as the preferred treatment for patients with ACS. We aim to systematically evaluate this transition to determine the relative efficacy of prasugrel versus ticagrelor in a real-world cohort of patients with ACS. Study design and objectives: The SWITCH SWEDEHEART trial is a prospective, multicenter, open-label, cross-sectional, stepped-wedge cluster-randomized clinical trial, in which administrative regions in Sweden will constitute the clusters. At the start of the study, all clusters will use ticagrelor as the P2Y12 inhibitor drug of choice for ACS. The order in which the clusters will implement the transition from ticagrelor to prasugrel will be randomly assigned. Every 9 months, 1 cluster will switch from ticagrelor to prasugrel as the P2Y12 inhibitor of choice for patients with ACS. The primary endpoint is the composite 1-year rate of the death, stroke, or myocardial infarction. Conclusions: The SWITCH SWEDEHEART study will provide an extensive randomized comparison between ticagrelor and prasugrel. Novel therapies are frequently costly and supported by evidence from few or small studies, and systematic evaluation after the introduction is rare. This study will establish an important standard for introducing and evaluating the effects of health care changes within our societies.

AB - Background: European treatment guidelines recommend prasugrel over ticagrelor for treating patients with non–ST-elevation acute coronary syndrome (ACS), prompting several Swedish administrative regions to transition from ticagrelor to prasugrel as the preferred treatment for patients with ACS. We aim to systematically evaluate this transition to determine the relative efficacy of prasugrel versus ticagrelor in a real-world cohort of patients with ACS. Study design and objectives: The SWITCH SWEDEHEART trial is a prospective, multicenter, open-label, cross-sectional, stepped-wedge cluster-randomized clinical trial, in which administrative regions in Sweden will constitute the clusters. At the start of the study, all clusters will use ticagrelor as the P2Y12 inhibitor drug of choice for ACS. The order in which the clusters will implement the transition from ticagrelor to prasugrel will be randomly assigned. Every 9 months, 1 cluster will switch from ticagrelor to prasugrel as the P2Y12 inhibitor of choice for patients with ACS. The primary endpoint is the composite 1-year rate of the death, stroke, or myocardial infarction. Conclusions: The SWITCH SWEDEHEART study will provide an extensive randomized comparison between ticagrelor and prasugrel. Novel therapies are frequently costly and supported by evidence from few or small studies, and systematic evaluation after the introduction is rare. This study will establish an important standard for introducing and evaluating the effects of health care changes within our societies.

UR - http://www.scopus.com/inward/record.url?scp=85132522001&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2022.05.017

DO - 10.1016/j.ahj.2022.05.017

M3 - Journal article

C2 - 35644221

AN - SCOPUS:85132522001

SN - 0002-8703

VL - 251

SP - 70

EP - 77

JO - American Heart Journal

JF - American Heart Journal

ER -

Rationale and design of switch Swedeheart: A registry-based, stepped-wedge, cluster-randomized, open-label multicenter trial to compare prasugrel and ticagrelor for treatment of patients with acute coronary syndrome

Abstract

Access to Document

Other files and links

Fingerprint

Cite this