Summary
Ticagrelor has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Type 2 Diabetes would be drug repurposing rather than first-in-human development. This does not mean it is approved for Type 2 Diabetes. ClinicalTrials.gov lists 8 registered trials linking Ticagrelor to Type 2 Diabetes: 5 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT04484259). The largest enrolment is 19271 participants (NCT01991795). Registration activity spans 2014 to 2021. The literature layer holds 7 publications for this pair: 1 Cochrane review, 1 randomised controlled trial publication and 5 clinical trial publications. Publication years run from 2012 to 2024. Because at least one synthesis-level source exists (systematic review, meta-analysis or Cochrane review), this pair has been assessed beyond single studies, although the synthesis may concern a different indication.
The RepurpOS disease-intelligence file for Type 2 Diabetes Mellitus ranks 767 candidate therapeutics from Open Targets, ChEMBL, DGIdb and PubMed; only a minority carry direct clinical evidence, and this page covers one of those. Spontaneous remission context recorded for the condition: 1.6-1.7% at 7 years on standard care (population-level cohorts UK and US).
Evidence table
| Evidence tier | A · Strong |
|---|---|
| Evidence score | 67.0 (trials 29.0, literature 18.0, tier 15, approved bonus 5.0) |
| Registered trials | 8 total: 0 recruiting, 0 active / not yet recruiting, 5 completed, 3 other |
| Linked publications | 7 (5 clinical trial publications, 1 Cochrane review, 1 randomised controlled trial publication) |
| Agent type | Drug (Small molecule) |
| Development stage (any indication) | Approved |
| Mechanism / class | Not recorded |
| Data sources | Open Targets, ChEMBL |
How the evidence score is calculated
- Each registered trial scores by status (recruiting / active / enrolling 3, completed 2.5, not yet recruiting 2, unknown 1, terminated / withdrawn / suspended 0.5) plus a phase bonus (phase 3-4 +2, phase 2 +1, phase 1 +0.5). The trial component is capped at 30.
- Each literature item scores by design (Cochrane review 5, meta-analysis 4, systematic review 3, RCT 3, clinical trial publication 2, curated reference 1.5, other PubMed record 1). The literature component is capped at 30.
- The existing evidence tier adds 15 (A / Strong), 10 (B / Moderate), 5 (C / Preliminary) or 0 (D / Anecdotal).
- Agents approved for any indication (max clinical phase 4) add 5, because an approved agent has an established safety profile that lowers the barrier to repurposing trials.
- The score ranks what has been studied, not what works. It does not read effect sizes or directions of effect.
Registered clinical trials
| NCT ID | Title | Status | Phase | Enrolment |
|---|---|---|---|---|
| NCT04484259 | Ticagrelor With and Without Aspirin in Patients With Diabetes Mellitus 2021 | completed | Phase 4 | 105 |
| NCT03437044 | Low Maintenance Dose Ticagrelor Versus Clopidogrel in Diabetes Patients Undergoing PCI 2018 | completed | Phase 4 | 40 |
| NCT02748330 | Platelet Inhibition of Ticagrelor Versus Clopidogrel in Type 2 Diabetic Patients After Elective Percutaneous Coronary Intervention 2016 | completed | Phase 4 | 40 |
| NCT02457130 | Comparison of TIcagrelor and Clopidogrel in Patients With Coronary Artery diseaSe and Type 2 Diabetes Mellitus (TICS-DM) 2015 | status unknown | Phase 4 | 30 |
| NCT02302508 | Pharmacokinetics of Antiplatelet Drugs in Diabetic pAtients 2019 | withdrawn | Phase 4 | — |
| NCT02325466 | Comparative Efficacy of Ticagrelor Versus Aspirin on Blood Viscosity in Peripheral Artery Disease Patients With Type 2 Diabetes 2015 | completed | Phase 3 | 70 |
| NCT01991795 | A Study Comparing Cardiovascular Effects of Ticagrelor Versus Placebo in Patients With Type 2 Diabetes Mellitus 2014 | completed | Phase 3 | 19,271 |
| NCT02214654 | A Pilot Study To Examine The Effects Of Ticagrelor To Protect Against Type 2 Diabetes-Induced Vascular Damage 2014 | status unknown | Not applicable | 144 |
Published literature
- Clinical trial publication Limb Outcomes With Ticagrelor Plus Aspirin in Patients With Diabetes Mellitus and AtherosclerosisBonaca MP, Bhatt DL, Simon T et al. · Journal of the American College of Cardiology · 2024 · PMID 38658101
- Clinical trial publication External applicability of the Effect of ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) trial: An analysis of patients with diabetes and coronary artery disease in the REduction of Atherothrombosis for Continued Health (REACH) registryAbtan J, Bhatt DL, Elbez Y et al. · International journal of cardiology · 2023 · PMID 36270493
- Clinical trial publication Cost-effectiveness of ticagrelor in patients with type 2 diabetes and coronary artery disease: a European economic evaluation of the THEMIS trialSteg PG, Bhatt DL, James SK et al. · European heart journal. Cardiovascular pharmacotherapy · 2022 · PMID 35488865
- Clinical trial publication Diabetes-Related Factors and the Effects of Ticagrelor Plus Aspirin in the THEMIS and THEMIS-PCI TrialsLeiter LA, Bhatt DL, McGuire DK et al. · Journal of the American College of Cardiology · 2021 · PMID 33985681
- Clinical trial publication Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trialBhatt DL, Steg PG, Mehta SR et al. · Lancet (London, England) · 2019 · PMID 31484629
- Randomized controlled trial Ticagrelor in Patients with Stable Coronary Disease and DiabetesSteg PG, Bhatt DL, Simon T et al. · The New England journal of medicine · 2019 · PMID 31475798
- Cochrane review Adenosine-diphosphate (ADP) receptor antagonists for the prevention of cardiovascular disease in type 2 diabetes mellitusValentine N, Van de Laar FA, van Driel ML · The Cochrane database of systematic reviews · 2012 · PMID 23152231
Mechanism and notes
No mechanism of action is recorded for this pair in the source databases.
OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Frequently asked questions
Is Ticagrelor approved for Type 2 Diabetes?
Ticagrelor has reached the approved stage (maximum clinical phase 4) for at least one indication, so its use in Type 2 Diabetes would be drug repurposing rather than first-in-human development. This does not mean it is approved for Type 2 Diabetes. Approval status for the specific indication should always be confirmed with the relevant regulator and prescribing information.
Is Ticagrelor in clinical trials for Type 2 Diabetes?
ClinicalTrials.gov lists 8 registered trials linking Ticagrelor to Type 2 Diabetes: 5 have completed; 3 are terminated, withdrawn, suspended or of unknown status. The most advanced is Phase 4 (NCT04484259). The largest enrolment is 19271 participants (NCT01991795). Registration activity spans 2014 to 2021.
What does the evidence show for Ticagrelor in Type 2 Diabetes?
Ticagrelor has both completed registered trials and synthesis-level publications linked to Type 2 Diabetes. That is the strongest profile in this database, but the summaries here do not extract effect sizes, so read the linked reviews for direction and magnitude of benefit. OSMF's existing evidence tier for this pair is A (Strong), derived from the strength of the disease association recorded in Open Targets and ChEMBL. The tier describes how well the drug-disease link is documented, not how well the drug works.
Cite this page
Data: ClinicalTrials.gov, PubMed, Open Targets, ChEMBL, DGIdb and the OSMF therapeutic agent database. Last updated 2026-07-05. Page built 2026-10-07.