A recent study, published in The New England Journal of Medicine, has found that a new drug could reduce the chances of having a heart attack.
If patients have atherosclerosis, which is a potentially serious condition where the arteries become clogged with fatty substances called plaques or atheroma, they can develop coronary heart disease and are at risk of heart attacks and strokes, amongst other conditions.
Current pharmaceutical intervention methods aim to slow down the process of atherosclerosis by focusing on reducing cholesterol (the drugs are targeted at reducing the plasma levels of cholesterol). Patients are, therefore, usually given cholesterol-lowering statins and blood thinning attacks to reduce the risk of heart attacks.
However, in this study, which involved 10,000 patients over 39 countries, patients were given canakinumab, which is an anti-inflammatory drug initially developed by the pharmaceutical company Novartis (which also sponsored the trial) to treat rheumatoid arthritis. The patients in the study, who had survived heart attacks or had a positive blood test for inflammation before the trial, were given injections of this targeted anti-inflammatory drug. They received high doses of statins as well as either canakinumab or a placebo, every three months, over a four year period.
The results of the study show that patients who received the canakinumab injection had a 15% lower chance of another heart attack, stroke or heart-related death over the next four years, compared to people given the placebo. The requirement for interventional procedures such as bypass surgery and inserting stents was reduced by 30%.
It was also found during the clinical trial that patients taking canakinumab had lower cancer death rates. In particular, the odds of developing lung cancer were reduced by 75%. However, whilst this is an exciting result, far more research and study is required.
Experts and researchers had previously suspected that there might be a link between inflammation of blood vessels and heart attacks but this had not been investigated – given that a substantial number of patients without cholesterol but with chronic inflammation experienced heart attacks. The clinical trial has, therefore, proven that inflammation contributes to the risk of cardiovascular events and that it can be reduced with anti-inflammatory drugs, such as canakinumab.
The findings come after another recent study, published in The New England Journal of Medicine earlier this year, revealed that a new drug called evolocumab reduced the risk of cardiovascular death, heart attack or stroke by 20%, compared with those taking the placebo, without any serious side effects, by reducing the levels of low density lipoprotein (LDL), or ‘bad’ cholesterol.
Although the canakinumab results are promising, there are side effects and other factors which need to be considered. Firstly, the drug is expensive, particularly in comparison to statins. Secondly, the study found that there was a higher incidence of severe infection amongst patients. However, it could be argued that the reduced risk of cancer (particularly lung cancer) offsets this risk.
Camilla Wonnacott, an associate in the clinical negligence team at Penningtons Manches LLP, who specialises in cardiology claims, said: “The results of this clinical trial are promising, not only from the perspective of reducing cardiovascular events but also due to the reduction in the development of lung cancer. Hopefully, with further clinical trials, researchers will be able to understand fully why this is and assess how patients can be protected in the future.”