AstraZeneca experimental blood thinner Brilinta (ticagrelor) got a recommendation from an FDA advisory panel Wednesday. AZ is seeking approval of the drug for reducing thrombotic events in patients with acute coronary syndromes, or heart attacks. One issue, though, caused debate among panelists: North American patients fared better on market leading Plavix than on Brilinta. These geographic differences could pose a commercial hurdle, said Bernstein analyst Tim Anderson. “Competitors Bristol-Myers Squibb/Sanofi-Aventis (who sell Plavix) and Eli Lilly/Daiichi Sankyo (who sell Effient) will very likely have marketing materials calling attention to that section of the Brilinta label describing the unfavorable US findings,” Anderson wrote in a research note. “They will also likely point out other attributes such as Brilinta's twice-daily dosing (versus their once-daily dosing) and side effects such as ventricular pauses and dyspnea (shortness of breath).” Payers may also limit Brilinta uptake once Plavix goes generic in 2012, Anderson pointed out.