A New Drug That Fights Off Heart Disease May Help Fight Off Cancer

A New Drug That Fights Off Heart Disease May Help Fight Off Cancer

USA-  Lowering inflammation may be as important in cutting cholesterol levels when it comes to heart disease, researchers say.

The researchers showed that using a targerted drug to reduce inflammation cut the risk of heart attacks, strokes and other "events" in patients who had already suffered one heart attack. The treatment also had a bonus side-effect which was that it appeared to have reduced rates of lung cancer diagnosis and death.

The research was presented at a meeting in Barcelona and it was just the first step and doesn't open a door to a new way of treating heart patients. It doesn't necessarily apply to everybody.

Dr. Paul Ridker of Brigham and Women's hospital and Harvard Medical School, who led the research team, think that the findings will lead to ways to help people most at risk of dying of heart disease and stroke. He says that this plays into the whole idea of personalized medicine and trying to get the right drug to the right patient.

Novartis, the maker of the drug, said it would ask the Food and Drug Administration for permission to market the drug as a way to prevent heart attacks and would start further tests on its effect in lung cancer.

10,000 patients who had suffered one heart attack already and that were at high risk of having a second one were tested by Ridker's team. All of the patients had high levels of high sensitivity C-reactive protein or CRP, a measure of inflammation in the body.

The patients were already taking many medications for their heart disease, from cholesterol-lowering statins to blood pressure drugs. The team added a drug called canakinumab, a monoclonal antibody or magic bullet agent that targets specific cause of inflammation called interleukin 1 beta.

People who volunteered for the study either got a placebo, or injections every three months of low, medium or high doses of canakinumab. After three to four years the people who got the highest dose of the drug were the least likely to have had another heart attack, stroke or to have died of heart disease.

Those who got  the two highest doses of canakinumab had a 15 percent lower chance of having a heart attack, stroke or other major cardiovascualar event. Patients were also less likely to need a heart bypass or angioplasty to clear out clogged arteries.

For the first time, the researchers have been able to definitevly show that lowering inflammation indepedent of cholesterol reduces cardiovascular risk said Dr. Ridker.

Dr. Steven Nissen, chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic, who was not involved in the study, said the results were impressive. He said it shows that people with high levels of inflammation who target the inflammation can reduce the risk of heart attack stroke and death.

Inflammation is part of the body's immune process, and the patients in the trial were more likely to suffer serious infections, including pneumonia. The same thing happens to people who take immune-suppressing drugs to fight rheumatoid arthritis. Physicians would need to be cautious, Ridker said.

The researchers found some other side effects. The people who took the higher doses of canakinumab had lower rates of cancer, especically lung cancer, as well as lower rates of arthritis and gout.

Dr. Ridker said that if you smoke a pack of cigarettes, you chronically inflame the lung. If you are a long-haul truck driver breathing in diesel, you are chronically inflamming the lung. Inflammation can driver cancer as well as heart diease. He does not believe that the drug prevents cancer. He thinks inflammation may fuel the growth of some tumours.

The findings of this study will not immediately mean new treatments for heart disease patients. Like any medical finding, they will need to be replicated by other researchers. Ridker is testing another drug, methotrexate, that is also used to treat rheumatoid arthritis.

Canakinumab has already been approved by the FDA, it is a so-called orphan drug used to treat a very rare genetic condition. It is sold under the brand name llaris and it costs about $200,000 a year.

Vas Narasimhan, who is the head of the drug development for Novartis says that they look forward to submitting the data to regulatory authorities for approval in cardiovascular and initating additional phase lll studies in lung cancer.

Ridker says he wants Novartis to try something different, like offering the first dose of the drug free. People whose CRP levels fell more after their first dose also tended to be those who had lower rates of heart attacks and strokes years later.

Some extreme heart disease patients will be helped more by the newest cholesterol-lowering drugs, called PCSK9 inhibitors, while others may be better helped by targeted anti-inflammatory drugs, says Ridker.

Nissen agrees with Ridker when he says half of heart attacks occur in people who do not have high cholesterol and for the first time they have been able to definitevly show that lowering inflammation independent of cholesterol reduces cardiovascular risk.


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