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For The First Time, Curbing Inflammation, Helps A Drug Lower Heart Risks

For The First Time, Curbing Inflammation, Helps A Drug Lower Heart Risks
In a new and very different approach than lowering cholesterol and in the focus for many years is a drug has helped prevent heart attacks by curbing inflammation, for the first time.
Especially from lung cancer, lower cancer death rates were also surprisingly noted among the people who were on the drug. But because the heart experiment wasn't intended to test the anti-tumor effect, even though it is an exciting possibility even while needing much more study.
A new frontier is opened up by the results on the drug, canakinumab (can-uh-KIN-yoo-mab), doctors say. With the main risk being chronic inflammation that can lead to clogged arteries can cause heart attacks for many even with normal cholesterol levels.
"We suddenly know we can address the inflammation itself, the same way we learned almost 25 years ago that we could address cholesterol. It's very exciting," said the study's leader, Dr. Paul Ridker of Brigham and Women's Hospital in Boston.
Presented at the European Society of Cardiology conference in Barcelona, Spain, the results of the research were published Sunday by the New England Journal of Medicine and Lancet. Ridker consults for the company while the drug's maker, Novartis, sponsored the study.
Along with smoking, blood pressure control and a healthy lifestyle, the cornerstone of preventing heart attacks have been statins such as Lipitor lower LDL or bad cholesterol.
Inflammation is a culprit in half of those cases of second heart attacks which occur in a one quarter of people who suffer a heart attack and the second attacks happens within five years.
While similar chemical responses can occur over time throughout the body with unhealthy habits, inflammation happens after a joint is injured and swells. arteries can be damaged and the stage for clots is set by that chronic, unseen inflammation.
A cheap blood test for a sign of inflammation called high-sensitivity C-reactive protein, or CRP was patented and its role was clarified by Ridker twenty years ago.
Canakinumab lowers CRP and is sold now under the brand name Ilaris for some rare inherited diseases.
10,000 heart attack survivors with low cholesterol but high CRP were specimens for the study tests. They were given one of three different doses of canakinumab or a placebo as a shot every three months and got the usual heart medicines.
Compared to people given dummy shots, those on the medium dose had a 15 percent lower chance of another heart attack, a stroke or a heart-related death over the next four years.
Repatha, a powerful new type of cholesterol-lowering drug called a PCSK9 inhibitor can be compared to Canakinumab's benefit. partly because many doctors hoped it would help more and due to its price — $14,000 a year, it had tepid sales after it came out two years ago.
However, the bad news is that about 1 of every 1,000 patients treated with Canakinumab were found to have raised risk of fatal infections. Most vulnerable were older people and diabetics.
Once cancer, infection and heart risks were balanced out, the drug had no effect on death rates.
"The fatal infections are something to be concerned about" but overall trends are in a good direction, said Dr. David Goff of the National Heart, Lung and Blood Institute.

Christopher J. Mitchell

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