A drug that fights inflammation can reduce the risk of heart attacks and strokes in people who have already had one heart attack and are at high risk for another, a new study finds.
“This is fantastic,” said Dr. David J. Maron, the director of preventive cardiology at Stanford University School of Medicine. “The green light just went on for full-fledged investigation and development of effective and cost-effective new therapies.”
The drug that was studied, canakinumab, is already marketed under the brand name Ilaris, but was approved to treat a type of juvenile rheumatoid arthritis and other rare disorders, not heart disease. It costs about $200,000 a year and is made by Novartis, which paid for the new study. The company declined to say whether the price would change if the drug came into more general use for heart disease.
Rather than focusing on the need to reduce cholesterol, as most statin medicines for treating heart disease do, the drug reduces inflammation - the response by the immune system to injury or infection. Inflammation is the new ‘hot topic’ among many medical practitioners and has been purportedly linked to a number of health issues in recent times. About half of people who have heart attacks have normal cholesterol levels, and researchers think that in some of them, inflammation may contribute to heart and artery disease.
Statins, which are generally used in cardiology patients, can also reduce inflammation, but not always as much as the newer drug. The new study included only people who had blood tests showing high levels of inflammation even though they were already taking statins and had lowered their “bad” LDL cholesterol to acceptable levels. The blood tests measured high-sensitivity C-reactive protein, a marker of inflammation, and high was defined as two milligrams or more per liter of blood.
“This is the first evidence we have that if you inhibit this inflammatory process without changing cholesterol at all, you’re getting a risk reduction,” said Dr. Paul M. Ridker, the first author of the study and director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital in Boston.
Dr. Daniel J. Rader, an expert in preventive cardiology at the University of Pennsylvania, who was not part of the study, said it offered “the first definitive clinical trial support for the concept that inflammation-targeted therapy reduces the risk of cardiovascular disease. I think that’s extraordinarily important.”
Although this breakthrough is substantial, some Doctors have warned that it should be limited to patients like the ones in the study - those who have already suffered heart attacks and those with high levels of inflammation. This suggestion comes as a result of identified risk factors associated with the new drug, such as infection. Furthermore, the cost of the drug is proving to be an issue.
Another, older and much cheaper anti-inflammatory drug, methotrexate, is also being studied to see if it can reduce cardiovascular risk, and Dr. Mosca said that if it works, it might be a more practical treatment. Dr. Ridker is also overseeing that study, which is being paid for by the federal government.The breakthrough study was published in The Lancet, and the information above was gathered from an article on the topic as published in the NY Times. You can read the full article here.
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