Study to Assess the Bioavailability of Ticagrelor OD Tablet vs. IR Tablet

• Sponsor: AstraZeneca (Industry)
• Overall Status: Completed
• CT.gov ID: NCT02400333
• Collaborator: (none)
• Enrollment: 100
• Location: 1
• Arms: 4
• Duration (Days): 30
• Patients Per Site Per Month: 101.5

Study Details

Study Description

Brief Summary

This study will be an open-label, randomised, four-period, four-treatment, crossover study in healthy male and female of non-childbearing potential subjects, performed at a single study centre.

The objective of the study is to assess the bioavailability of ticagrelor orodispersible (OD) tablets when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor immediate-release (IR) tablets

Condition or Disease	Intervention/Treatment	Phase
Bioavailability; Healthy Subjects	Drug: Ticagrelor OD tablet (90 mg single dose) administered with 200 ml of water; Drug: Ticagrelor OD tablet (90 mg single dose) administered without water; Drug: Ticagrelor OD tablet (90 mg single dose) suspended in water administered via nasogastric tube; Drug: Brilique®, Ticagrelor IR tablet (90 mg) administered with 200mL of water	Phase 1

Detailed Description

Study to evaluate the bioavailability of ticagrelor OD tablets administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.

Study Design

• Study Type: Interventional
• Actual Enrollment: 100 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Masking: None (Open Label)
• Primary Purpose: Basic Science
• Official Title: An Open-label, Randomised, Four-period, Four-treatment, Crossover, Single-centre, Single-dose Study to Assess the Bioavailability of Ticagrelor Orodispersible Tablets, Compared to Ticagrelor Immediate-release Tablets in Healthy Subjects
• Study Start Date: Jun 1, 2015
• Actual Primary Completion Date: Jul 1, 2015
• Actual Study Completion Date: Jul 1, 2015

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Treatments A-D-B-C sequence Treatment A in Period 1, Treatment D in Period 2, Treatment B in Period 3 and Treatment C in Period 4	Drug: Ticagrelor OD tablet (90 mg single dose) administered with 200 ml of water; 90 mg single dose; Other Names: Treatment A ; Drug: Ticagrelor OD tablet (90 mg single dose) administered without water; 90 mg single dose; Other Names: Treatment B ; Drug: Ticagrelor OD tablet (90 mg single dose) suspended in water administered via nasogastric tube; 90 mg single dose; Other Names: Treatment C ; Drug: Brilique®, Ticagrelor IR tablet (90 mg) administered with 200mL of water; 90 mg single dose; Other Names: Treatment D
Experimental: Treatments B-A-C-D sequence Treatment B in Period 1, Treatment A in Period 2, Treatment C in Period 3 and Treatment D in Period 4	Drug: Ticagrelor OD tablet (90 mg single dose) administered with 200 ml of water; 90 mg single dose; Other Names: Treatment A ; Drug: Ticagrelor OD tablet (90 mg single dose) administered without water; 90 mg single dose; Other Names: Treatment B ; Drug: Ticagrelor OD tablet (90 mg single dose) suspended in water administered via nasogastric tube; 90 mg single dose; Other Names: Treatment C ; Drug: Brilique®, Ticagrelor IR tablet (90 mg) administered with 200mL of water; 90 mg single dose; Other Names: Treatment D
Experimental: Treatments C-B-D-A sequence Treatment C in Period 1, Treatment B in Period 2, Treatment D in Period 3 and Treatment A in Period 4	Drug: Ticagrelor OD tablet (90 mg single dose) administered with 200 ml of water; 90 mg single dose; Other Names: Treatment A ; Drug: Ticagrelor OD tablet (90 mg single dose) administered without water; 90 mg single dose; Other Names: Treatment B ; Drug: Ticagrelor OD tablet (90 mg single dose) suspended in water administered via nasogastric tube; 90 mg single dose; Other Names: Treatment C ; Drug: Brilique®, Ticagrelor IR tablet (90 mg) administered with 200mL of water; 90 mg single dose; Other Names: Treatment D
Experimental: Treatments D-C-A-B sequence Treatment D in Period 1, Treatment C in Period 2, Treatment A in Period 3 and Treatment B in Period 4	Drug: Ticagrelor OD tablet (90 mg single dose) administered with 200 ml of water; 90 mg single dose; Other Names: Treatment A ; Drug: Ticagrelor OD tablet (90 mg single dose) administered without water; 90 mg single dose; Other Names: Treatment B ; Drug: Ticagrelor OD tablet (90 mg single dose) suspended in water administered via nasogastric tube; 90 mg single dose; Other Names: Treatment C ; Drug: Brilique®, Ticagrelor IR tablet (90 mg) administered with 200mL of water; 90 mg single dose; Other Names: Treatment D

Outcome Measures

Primary Outcome Measures

1. Maximum Observed Plasma Concentration (Cmax) of Ticagrelor and Its Active Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).

2. Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Quantifiable Analyte Concentration (AUC[0-t]) of Ticagrelor and Its Active Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).

3. Area Under Plasma Concentration-time Curve From Zero to Infinity (AUC [0-∞]). [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).

Secondary Outcome Measures

1. Time to Reach Maximum Observed Concentration (Tmax) of Ticagrelor and Its Active Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).

2. Half-life Associated With Terminal Slope (λz) of a Semi-logarithmic Concentration-time Curve (t½λz) of Ticagrelor and Its Active Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).

3. Ratio of Metabolite Cmax to Parent Cmax, Adjusted for Differences in Molecular Weights (MRCmax) of Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Assesssment of MRCmax (ratio of metabolite Cmax to parent Cmax, adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.

4. Ratio of Metabolite AUC(0-t) to Parent AUC(0-t), Adjusted for Differences in Molecular Weights (MRAUC[0-t]) of Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Assesssment of MRAUC(0-t) (Ratio of metabolite AUC(0-t) to parent AUC(0-t), adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.

5. Ratio of Metabolite AUC [0-∞] to Parent AUC [0-∞], Adjusted for Differences in Molecular Weights (MRAUC [0-∞]) of Metabolite AR-C124910XX. [0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.]

   Assesssment of MRAUC [0-∞] (Ratio of metabolite AUC [0-∞] to parent AUC [0-∞], adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.

6. Percentage of Participants With Adverse Events (AEs). [SAEs were recorded from the signing of informed consent and AEs were recorded from randomisation until the final follow-up visit.]

   An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. The term AE is used generally to include any AE whether serious or non-serious. A serious AE (SAE) is an AE that fulfills one or more of the following criteria: results in death, is immediately life-threatening; requires in-patient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability or incapacity or substantial disruption of the ability to conduct normal life functions; is a congenital abnormality or birth defect; is an important medical event that may jeopardize the participant or may require medical intervention to prevent one of the outcomes listed above.

7. Mean Change From Baseline for Vital Signs of Supine Blood Pressure (SBP) and Diastolic BP (DBP). [Day 1 (2, 4 hours post-dose) and Day 2 (24 hours post-dose).]

   The following variables were collected after the participants had rested in the supine position for at least 5 minutes: SBP and DBP.

8. Mean Change From Baseline for Vital Signs in Supine Pulse Rate. [Day 1 (2, 4 hours post-dose) and Day 2 (24 hours post-dose).]

   Vital signs were collected after the participant has rested in the supine position for at least 5 minutes.

9. Participants With Significant Findings in 12-Lead Electrocardiography (ECG). [At screening and at follow-up.]

   A 12-lead ECG was obtained after the participant rested in supine position for at least 10 minutes. The study physician was to judge the overall interpretation as normal or abnormal. If abnormal, it was decided as to whether or not the abnormality was clinically significant and the reason for the abnormality was recorded.

10. Participants With Clinically Significant Findings in Hematology, Clinical Chemistry and Urinalysis. [At screening, at admission on Day -1 to each treatment period and at follow-up.]

    Participants were assessed through each laboratory variables for any significant abnormalities. Hematology assessments included white blood cell count, red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and others. Clinical chemistry assessment included testing levels of sodium, potassium, urea, creatinine, albumin, calcium, glucose (fasting) and others. Urinalysis assessment included glucose, protein, blood and microscopy (if positive for blood or protein).

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years to 55 Years
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Inclusion Criteria:

Healthy male and female subjects aged 18 to 55 years with suitable veins for cannulation or repeated venepuncture. - Females must have a negative pregnancy test at screening and on each admission to the clinical unit, must not be lactating, and must be of non-childbearing potential, confirmed at screening by fulfilling one of the following criteria: Postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of all exogenous hormonal treatments and follicle-stimulating hormone (FSH) levels in the postmenopausal range or Documentation of irreversible surgical sterilisation by hysterectomy, bilateral oophorectomy or bilateral salpingectomy but not tubal ligation. - Have a body mass index (BMI) between 18.5 and 29.9 kg/m2 inclusive and weigh at least 50 kg and no more than 100 kg inclusive. -Able to understand, read and speak the German language.

Exclusion Criteria: - History of any clinically significant disease or disorder which, in the opinion of the investigator, may either put the potential subject at risk because of participation in the study, or influence the results or the potential subject's ability to participate in the study.

• Any abnormalities in alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), urea, creatinine, thyroid-stimulating hormone (TSH), International Normalised Ratio (INR), activated partial thromboplastin time (aPTT), white blood cell (WBC) count, haemoglobin (Hb) or platelet count. Any other abnormal haematology, clinical chemistry, coagulation or urinalysis results, as judged with an unacceptable deviation that is considered to be clinically significant by the investigator.

• Any clinically significant abnormal findings in vital signs, as judged by the investigator. at screening and at baseline (Day -1 of Treatment period 1), defined as:

• Systolic blood pressure < 90mmHg or ≥ 140 mmHg

• Diastolic blood pressure < 50mmHg or ≥ 90 mmHg

• Pulse < 50 or > 85 beats per minute (bpm)

• Current smokers or those who have smoked or used nicotine products within the previous 3 months.

• History of haemophilia, von Willebrand's disease, lupus anticoagulant, or other diseases/syndromes that can either alter or increase the propensity for bleeding.

• A personal history of vascular abnormalities including aneurysms; a personal history of severe haemorrhage, hematemesis, melena, haemoptysis, severe epistaxis, severe thrombocytopenia, intracranial haemorrhage; or rectal bleeding within 1 year prior to screening; or history suggestive of peptic ulcer disease; or at the discretion of the investigator.

• History of a clinically significant non-traumatic bleed or clinically significant bleeding risk, as judged by the investigator.

• Use of aspirin, ibuprofen, non-steroidal anti-inflammatory drugs (NSAIDs), or any other drug known to increase the propensity for bleeding for 2 weeks before randomisation.

• Platelet count less than 150 x 109/L.

Criteria applicable to insertion of a nasogastric tube:

• History of severe midface trauma and/or recent nasal surgery.

• History of coagulation abnormality, oesophageal varices or stricture, recent banding or cautery of oesophageal varices, and/or alkaline ingestion, at the discretion of the investigator.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Research Site	Berlin		Germany

Sponsors and Collaborators

• AstraZeneca

Investigators

• Principal Investigator: Rainard Fuhr, Dr. med., PAREXEL International GmbH, Berlin

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: AstraZeneca
• ClinicalTrials.gov Identifier: NCT02400333
• Other Study ID Numbers: D5139C00003
• First Posted: Mar 27, 2015
• Last Update Posted: Sep 29, 2016
• Last Verified: Aug 1, 2016

• Keywords provided by AstraZeneca: ticagrelor orodispersible tablet; ticagrelor immediate-release tablet; relative bioavailability; Phase I; healthy subjects
• Additional relevant MeSH terms: Ticagrelor

Study Results

Participant Flow

Recruitment Details	This study was conducted at PAREXEL International, Early Phase Clinical Unit Berlin, Berlin, Germany. In this study, 100 participants were screened, out of which 36 were randomized and treated.
Pre-assignment Detail	Participants were randomized in 4 sequence Williams design for 4 periods and 4 treatments:Ticagrelor orodispersible (OD) tablets with water (Treatment A);Ticagrelor OD tablets without water (Treatment B);Ticagrelor OD tablets suspended in water through nasogastric tube (Treatment C);Ticagrelor immediate-release (IR) tablets with water(Treatment D).

Arm/Group Title	ADBC Sequence	BACD Sequence	CBDA Sequence	DCAB Sequence
Arm/Group Description	Treatment A in Period 1, Treatment D in Period 2, Treatment B in Period 3 and Treatment C in Period 4.	Treatment B in Period 1, Treatment A in Period 2, Treatment C in Period 3 and Treatment D in Period 4.	Treatment C in Period 1, Treatment B in Period 2, Treatment D in Period 3 and Treatment A in Period 4.	Treatment D in Period 1, Treatment C in Period 2, Treatment A in Period 3 and Treatment B in Period 4.
Period Title: Overall Study
STARTED	9	9	9	9
COMPLETED	8	8	7	7
NOT COMPLETED	1	1	2	2

Baseline Characteristics

Arm/Group Title	ADBC Sequence	BACD Sequence	CBDA Sequence	DCAB Sequence	Total
Arm/Group Description	Treatment A in Period 1, Treatment D in Period 2, Treatment B in Period 3 and Treatment C in Period 4.	Treatment B in Period 1, Treatment A in Period 2, Treatment C in Period 3 and Treatment D in Period 4.	Treatment C in Period 1, Treatment B in Period 2, Treatment D in Period 3 and Treatment A in Period 4.	Treatment D in Period 1, Treatment C in Period 2, Treatment A in Period 3 and Treatment B in Period 4.	Total of all reporting groups
Overall Participants	9	9	9	9	36
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	42 (12)	44 (12)	42 (13)	40 (13)	42 (12)
Sex: Female, Male (Count of Participants)
Female	1 11.1%	1 11.1%	1 11.1%	1 11.1%	4 11.1%
Male	8 88.9%	8 88.9%	8 88.9%	8 88.9%	32 88.9%

Outcome Measures

1. Primary Outcome

Title	Maximum Observed Plasma Concentration (Cmax) of Ticagrelor and Its Active Metabolite AR-C124910XX.
Description	Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The Pharmacokinetic (PK) analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a nasogastric tube (NG) tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Ticagrelor	428 (25.0)	499 (34.0)	479 (32.1)	520 (29.0)
AR-C124910XX	118 (26.5)	126 (24.7)	126 (30.4)	129 (31.8)

Statistical Analysis 1

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	84.85
	Confidence Interval	(2-Sided) 90%; 76.77 to 93.78
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 2

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	96.61
	Confidence Interval	(2-Sided) 95%; 88.22 to 105.79
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 3

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	92.16
	Confidence Interval	(2-Sided) 95%; 85.59 to 99.25
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 4

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	89.84
	Confidence Interval	(2-Sided) 95%; 82.03 to 98.39
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 5

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	97.45
	Confidence Interval	(2-Sided) 95%; 90.53 to 104.90
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 6

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	97.07
	Confidence Interval	(2-Sided) 95%; 90.83 to 103.74
	Parameter Dispersion	Type: Value:
	Estimation Comments

2. Primary Outcome

Title	Area Under the Plasma Concentration-time Curve From Time Zero to Time of Last Quantifiable Analyte Concentration (AUC[0-t]) of Ticagrelor and Its Active Metabolite AR-C124910XX.
Description	Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Ticagrelor	3023 (28.6)	3172 (42.6)	3174 (40.9)	3358 (40.0)
AR-C124910XX	1087 (19.7)	1104 (20.7)	1101 (24.4)	1140 (23.0)

Statistical Analysis 1

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	95.04
	Confidence Interval	(2-Sided) 95%; 90.33 to 99.99
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 2

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	95.41
	Confidence Interval	(2-Sided) 95%; 89.94 to 101.21
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 3

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	94.66
	Confidence Interval	(2-Sided) 95%; 90.53 to 98.98
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 4

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	94.67
	Confidence Interval	(2-Sided) 95%; 90.94 to 98.56
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 5

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	96.00
	Confidence Interval	(2-Sided) 95%; 91.87 to 100.33
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 6

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	96.56
	Confidence Interval	(2-Sided) 95%; 93.08 to 100.17
	Parameter Dispersion	Type: Value:
	Estimation Comments

3. Primary Outcome

Title	Area Under Plasma Concentration-time Curve From Zero to Infinity (AUC [0-∞]).
Description	Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Ticagrelor	3068 (29.2)	3228 (44.2)	3226 (42.9)	3423 (41.8)
AR-C124910XX	1138 (19.1)	1155 (20.7)	1154 (23.6)	1197 (22.5)

Statistical Analysis 1

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	94.96
	Confidence Interval	(2-Sided) 95%; 90.27 to 99.89
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 2

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	95.24
	Confidence Interval	(2-Sided) 95%; 89.81 to 100.99
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 3

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of ticagrelor relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	94.40
	Confidence Interval	(2-Sided) 95%; 90.26 to 98.73
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 4

Statistical Analysis Overview	Comparison Group Selection	Treatment A, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered with water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	94.82
	Confidence Interval	(2-Sided) 95%; 91.36 to 98.42
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 5

Statistical Analysis Overview	Comparison Group Selection	Treatment B, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets administered without water compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	95.71
	Confidence Interval	(2-Sided) 95%; 91.78 to 99.82
	Parameter Dispersion	Type: Value:
	Estimation Comments

Statistical Analysis 6

Statistical Analysis Overview	Comparison Group Selection	Treatment C, Treatment D
	Comments	Statistical assessment of metabolite AR-C124910XX relative bioavailability following ticagrelor OD tablets suspended in water and administered through NG tube compared to ticagrelor IR tablets.
	Type of Statistical Test	Superiority or Other
	Comments
Statistical Test of Hypothesis	p-Value
	Comments
	Method
	Comments
Method of Estimation	Estimation Parameter	Geometric mean ratio
	Estimated Value	96.50
	Confidence Interval	(2-Sided) 95%; 93.26 to 99.87
	Parameter Dispersion	Type: Value:
	Estimation Comments

4. Secondary Outcome

Title	Time to Reach Maximum Observed Concentration (Tmax) of Ticagrelor and Its Active Metabolite AR-C124910XX.
Description	Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Ticagrelor	2.02	2.00	2.00	2.00
AR-C124910XX	3.00	3.00	2.00	2.00

5. Secondary Outcome

Title	Half-life Associated With Terminal Slope (λz) of a Semi-logarithmic Concentration-time Curve (t½λz) of Ticagrelor and Its Active Metabolite AR-C124910XX.
Description	Blood samples for the determination of plasma concentrations of both ticagrelor and AR-C124910XX were collected at pre-dose (0 hours) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours (14 samples per treatment period).
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Ticagrelor	8.02 (1.25)	8.21 (1.46)	7.99 (1.83)	8.18 (1.71)
AR-C124910XX	9.48 (1.43)	9.35 (1.81)	9.36 (2.18)	9.47 (2.02)

6. Secondary Outcome

Title	Ratio of Metabolite Cmax to Parent Cmax, Adjusted for Differences in Molecular Weights (MRCmax) of Metabolite AR-C124910XX.
Description	Assesssment of MRCmax (ratio of metabolite Cmax to parent Cmax, adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Geometric Mean (Geometric Coefficient of Variation) [ratio]	0.300 (27.5)	0.277 (40.1)	0.286 (33.3)	0.271 (32.6)

7. Secondary Outcome

Title	Ratio of Metabolite AUC(0-t) to Parent AUC(0-t), Adjusted for Differences in Molecular Weights (MRAUC[0-t]) of Metabolite AR-C124910XX.
Description	Assesssment of MRAUC(0-t) (Ratio of metabolite AUC(0-t) to parent AUC(0-t), adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Geometric Mean (Geometric Coefficient of Variation) [ratio]	0.393 (29.8)	0.380 (42.7)	0.379 (43.2)	0.371 (43.4)

8. Secondary Outcome

Title	Ratio of Metabolite AUC [0-∞] to Parent AUC [0-∞], Adjusted for Differences in Molecular Weights (MRAUC [0-∞]) of Metabolite AR-C124910XX.
Description	Assesssment of MRAUC [0-∞] (Ratio of metabolite AUC [0-∞] to parent AUC [0-∞], adjusted for differences in molecular weights) of ticagrelor and its active metabolite AR-C124910XX following single doses of the OD tablet when administered with water, without water and suspended in water to be administered through nasogastric tubes, compared to ticagrelor IR tablets.
Time Frame	0 hours (pre-dose) and post-dose at 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16, 24, 36 and 48 hours in each treatment period.

Outcome Measure Data

Analysis Population Description

The PK analysis set consisted of all participants in the safety analysis set for whom at least one of the primary PK parameters, for a given analyte, can be calculated for at least two treatment periods and who had no major protocol deviations.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	30	31	33	33
Geometric Mean (Geometric Coefficient of Variation) [ratio]	0.405 (30.0)	0.391 (42.4)	0.391 (42.2)	0.382 (43.1)

9. Secondary Outcome

Title	Percentage of Participants With Adverse Events (AEs).
Description	An AE is the development of an undesirable medical condition or the deterioration of a pre-existing medical condition following or during exposure to a pharmaceutical product, whether or not considered causally related to the product. The term AE is used generally to include any AE whether serious or non-serious. A serious AE (SAE) is an AE that fulfills one or more of the following criteria: results in death, is immediately life-threatening; requires in-patient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability or incapacity or substantial disruption of the ability to conduct normal life functions; is a congenital abnormality or birth defect; is an important medical event that may jeopardize the participant or may require medical intervention to prevent one of the outcomes listed above.
Time Frame	SAEs were recorded from the signing of informed consent and AEs were recorded from randomisation until the final follow-up visit.

Outcome Measure Data

Analysis Population Description

The safety analysis set included all participants who received at least one dose of ticagrelor and for whom any safety post-dose data were available.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	31	32	34	33
AEs	9.7 107.8%	15.6 173.3%	8.8 97.8%	6.1 67.8%
SAEs	0 0%	0 0%	0 0%	0 0%

10. Secondary Outcome

Title	Mean Change From Baseline for Vital Signs of Supine Blood Pressure (SBP) and Diastolic BP (DBP).
Description	The following variables were collected after the participants had rested in the supine position for at least 5 minutes: SBP and DBP.
Time Frame	Day 1 (2, 4 hours post-dose) and Day 2 (24 hours post-dose).

Outcome Measure Data

Analysis Population Description

The safety analysis set included all participants who received at least one dose of ticagrelor and for whom any safety post-dose data were available.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	31	32	34	33
SBP - Day 1, 2h Post-dose	-2 (8)	-2 (7)	-1 (8)	3 (8)
SBP - Day 1, 4 Post-dose	0 (9)	1 (8)	-1 (9)	2 (8)
SBP - Day 2, 24h Post-dose	-2 (6)	-1 (9)	-3 (8)	1 (10)
DBP - Day 1, 2h Post-dose	-1 (6)	-1 (5)	-4 (6)	0 (5)
DBP - Day 1, 4 Post-dose	0 (5)	-1 (4)	-3 (5)	0 (5)
DBP - Day 2, 24h Post-dose	0 (6)	-3 (5)	-3 (6)	-1 (6)

11. Secondary Outcome

Title	Mean Change From Baseline for Vital Signs in Supine Pulse Rate.
Description	Vital signs were collected after the participant has rested in the supine position for at least 5 minutes.
Time Frame	Day 1 (2, 4 hours post-dose) and Day 2 (24 hours post-dose).

Outcome Measure Data

Analysis Population Description

The safety analysis set included all participants who received at least one dose of ticagrelor and for whom any safety post-dose data were available.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	31	32	34	33
Day 1, 2h Post-dose	0 (5)	-1 (5)	-1 (6)	0 (5)
Day 1, 4 Post-dose	1 (6)	-1 (6)	-1 (7)	2 (5)
Day 2, 24h Post-dose	0 (6)	1 (7)	1 (7)	1 (7)

12. Secondary Outcome

Title	Participants With Significant Findings in 12-Lead Electrocardiography (ECG).
Description	A 12-lead ECG was obtained after the participant rested in supine position for at least 10 minutes. The study physician was to judge the overall interpretation as normal or abnormal. If abnormal, it was decided as to whether or not the abnormality was clinically significant and the reason for the abnormality was recorded.
Time Frame	At screening and at follow-up.

Outcome Measure Data

Analysis Population Description

The safety analysis set included all participants who received at least one dose of ticagrelor and for whom any safety post-dose data were available.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	31	32	34	33
Number [participants]	0 (6) 0%	0 (7) 0%	0 (7) 0%	0 (7) 0%

13. Secondary Outcome

Title	Participants With Clinically Significant Findings in Hematology, Clinical Chemistry and Urinalysis.
Description	Participants were assessed through each laboratory variables for any significant abnormalities. Hematology assessments included white blood cell count, red blood cell count, hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin and others. Clinical chemistry assessment included testing levels of sodium, potassium, urea, creatinine, albumin, calcium, glucose (fasting) and others. Urinalysis assessment included glucose, protein, blood and microscopy (if positive for blood or protein).
Time Frame	At screening, at admission on Day -1 to each treatment period and at follow-up.

Outcome Measure Data

Analysis Population Description

The safety analysis set included all participants who received at least one dose of ticagrelor and for whom any safety post-dose data were available.

Arm/Group Title	Treatment A	Treatment B	Treatment C	Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.	Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.	Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).	Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
Measure Participants	31	32	34	33
Number [participants]	0 0%	0 0%	0 0%	0 0%

Adverse Events

Time Frame	Serious adverse events were recorded from the signing of the informed consent and adverse events were recorded from randomization until the final follow-up visit.
Arm/Group Title	Treatment A		Treatment B		Treatment C		Treatment D
Arm/Group Description	Participants received Ticagrelor OD tablets administered with water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with 200 mL noncarbonated water at room temperature.		Participants received Ticagrelor OD tablets administered without water. The OD tablet was placed on the tongue to disintegrate and be swallowed subsequently with saliva.		Participants received Ticagrelor OD tablets suspended in water to be administered through a NG tube into the stomach (total of 200 mL of water).		Participants received Ticagrelor IR tablets administered orally with 200 mL of water.
All Cause Mortality
	Treatment A		Treatment B		Treatment C		Treatment D
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	/ (NaN)		/ (NaN)		/ (NaN)		/ (NaN)
Serious Adverse Events
	Treatment A		Treatment B		Treatment C		Treatment D
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/31 (0%)		0/32 (0%)		0/34 (0%)		0/33 (0%)
Other (Not Including Serious) Adverse Events
	Treatment A		Treatment B		Treatment C		Treatment D
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	3/31 (9.7%)		5/32 (15.6%)		3/34 (8.8%)		2/33 (6.1%)
Gastrointestinal disorders
Diarrhoea	0/31 (0%)		0/32 (0%)		1/34 (2.9%)		0/33 (0%)
Nausea	1/31 (3.2%)		0/32 (0%)		0/34 (0%)		0/33 (0%)
General disorders
Chest pain	0/31 (0%)		0/32 (0%)		1/34 (2.9%)		0/33 (0%)
Fatigue	0/31 (0%)		1/32 (3.1%)		0/34 (0%)		0/33 (0%)
Nervous system disorders
Dizziness	1/31 (3.2%)		1/32 (3.1%)		0/34 (0%)		0/33 (0%)
Headache	0/31 (0%)		1/32 (3.1%)		0/34 (0%)		0/33 (0%)
Paraesthesia	1/31 (3.2%)		0/32 (0%)		0/34 (0%)		0/33 (0%)
Respiratory, thoracic and mediastinal disorders
Dyspnoea	1/31 (3.2%)		0/32 (0%)		0/34 (0%)		1/33 (3%)
Throat irritation	0/31 (0%)		0/32 (0%)		1/34 (2.9%)		0/33 (0%)
Skin and subcutaneous tissue disorders
Rash	0/31 (0%)		0/32 (0%)		0/34 (0%)		1/33 (3%)
Vascular disorders
Thrombophlebitis	0/31 (0%)		2/32 (6.3%)		0/34 (0%)		1/33 (3%)
Haematoma	0/31 (0%)		0/32 (0%)		0/34 (0%)		1/33 (3%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

If a publication (e.g., in a scientific journal) based on the results of this study is envisaged, approval from AstraZeneca will be obtained and a draft manuscript will be submitted to AstraZeneca for scrutiny and comment. The choice of conduit will be mutually agreed on by the Principal Investigator and AstraZeneca.