A study carried out by researchers from multiple institutions across the globe has found that an innovative new drug could help prevent heart attacks by significantly cutting ‘bad’ cholesterol.
Over 27,000 people across 49 counties, including the UK, took part in the trial, which consisted of giving the participants either injections of the new drug, evolocumab, or an identical dummy injection alongside their current statin. They were then followed up for two years.
All the participants in the trial had evidence of cardiovascular disease and some had a history of heart attack, strokes caused by a blood clot, or symptomatic artery disease.
The results of the study, which were published in the New England Journal of Medicine this month, revealed that evolocumab reduced the risk of cardiovascular death, heart attack or stroke by 20%, compared with those taking the placebo. There were no serious side effects. The participants in the study were already taking statins.
Around 15 million people worldwide die from heart attacks or strokes each year and these findings represent a huge step forward in preventing heart attacks. The study shows that evolocumab, along with statins, dramatically reduced the levels of low density lipoprotein (LDL), or ‘bad’ cholesterol. If there is too much cholesterol for the cells to use, ‘bad’ cholesterol can build up in the arteries, which can easily become blocked causing a heart attack or stroke.
Evolocumab is specifically designed to target and inhibit an enzyme in the liver, PCSK9, which hinders the liver's ability to remove LDL cholesterol from the body. By stopping it working, evolocumab essentially increases the liver's effectiveness.
Professor Peter Sever, from Imperial College London, who organised the UK part of the trial, told the BBC that evolocumab was ‘much more effective than statins’ and that the ‘20% reduction in risk was a big effect’.
At present, evolocumab is licensed for use in patients with high cholesterol who are either intolerant to statins or have not achieved sufficient reduction in LDL cholesterol with statins alone. Current UK guidelines state it should only be funded by the NHS if a person is at high risk of cardiovascular disease and has persistently high blood cholesterol levels. The drug is relatively new and the extent of the long-term benefit will need to be investigated.
Camilla Wonnacott, an associate in the clinical negligence team and member of the cardiology specialist team at Penningtons Manches LLP, said: “Millions of people around the world have ‘bad’ cholesterol. The fact that this new drug can reduce the risk of cardiovascular events by such a large percentage is very promising and we hope that further investigations will be undertaken to consider its potential applications fully.”