Protecting the pipeline of science: Openness, scientific methods and the lessons from ticagrelor and the PLATO trial

Ticagrelor

“…A series of critical articles, largely by the same two authors, and refuted by the PLATO investigators, have raised a multitude of concerns regarding the PLATO trial, including: worse outcome for US patients which were monitored by an independent organisation; higher rate of all‐cause death in clopidogrel‐treated patients compared to previous studies; obvious differences in the shape of the tablets which may have led to unblinded bias; and differences in the classification of diagnosis of MI …”

“…The PLATO trial controversy is still ongoing and is likely to continue until more data are available. In addition to any further sources of bias, it highlights some potential limitations of peer‐review processes, and problems in free access to clinical trial data and data sharing …”

Side effects of ticagrelor: Sinus node dysfunction with ventricular pause

“…The PLATO study has demonstrated that treatment with ticagrelor (versus clopidogrel) significantly reduced the rate of a composite primary end point (death from vascular causes, myocardial infarction or stroke) in patients presenting with acute coronary syndrome [1,2]. However, some adverse effects may occur [3][4][5][6].…”