New anti-inflammation drug cuts risk of heart disease

The anti-inflammatory drug canakinumab can reduce the risk of repeat heart attacks and other acute coronary events, claims the results of a four-year trial published in The New England Journal of Medicine.

Dr Paul Ridker, lead author of the study, said:  “This has far-reaching implications. It tells us that by leveraging an entirely new way to treat patients – targeting inflammation – we may be able to significantly improve outcomes for certain very high-risk populations.”

The trial included 10 000 patients that had previously suffered a myocardial infarction between April 2011 and March 2014. Participants were randomised and given placebo or canakinumab at a dose of either 50mg, 150mg, or 300mg (all administered subcutaneously once every 3 months). Results showed that in the group given 150mg of canakinumab there was a 15% reduction in the risk of a repeat heart attack when compared with the placebo group, and a 17% reduction in the risk of a further acute coronary event. The results were similarly effective between the 150mg and 300mg group, whilst the 50mg group showed no statistically significant difference to participants using placebo.

Statins are currently the primary treatment offered to patients after a myocardial infarction to lower their cholesterol. However, around 25% of people will still suffer a repeat heart attack after five years, despite being treated with statins. This recurrence is believed to be sometimes associated with inflammation in the heart’s arteries, which some experts argue can be reduced when combining canakinumab and statin therapy.

Professor Jeremy Pearson, associate medical director at the British Heart Foundation, said: “Statins are given to these people to reduce their risk of another heart attack and this undoubtedly saves lives. But we know that lowering cholesterol alone is not always enough. These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and [lowering it] could help save lives.”

In an unexpected result, participants in the trail that were given higher doses of canakinumab also had their risk of cancer across all types halved when compared to the placebo group. In lung cancer this difference was particularly pronounced, with patients given canakinumab seeing a 75% reduction in risk. The authors of the study were unable to account for this result, but further trials are planned to investigate the cause behind the reduction in cancer risk.

However, the study also showed that there was a significantly higher incidence of people suffering sepsis or a fatal infection as a side-effect of taking canakinumab, with death from a severe infection in around one in every 1000 people treated with the drug. There are also further questions around the drug’s cost-effectiveness in relation to its efficacy. 

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