Associated Press November 19, 2019 10:52 AM 8 hours ago
Novel drugs may
offer fresh ways to reduce heart risks beyond the usual medicines to lower
cholesterol and blood pressure.
One new study
found that heart attack survivors benefited from a medicine long used to treat
gout. Several experimental drugs also showed early promise for interfering with
heart-harmful genes without modifying the genes themselves — in one case, with
treatment just twice a year.
The research was
featured at an American Heart Association conference ending Monday in
Philadelphia.
"There's a
lot of excitement" about the new gene-targeting medicines, especially
because they seem to last so long, said Dr. Karol Watson, of the University of
California, Los Angeles.
Scientists have
been exploring gene therapy — altering DNA — to attack the root cause of many
diseases. The new drugs essentially accomplish the same thing without tampering
with genes, said the University of Pennsylvania's Dr. Daniel Rader, who has
consulted for some makers of these drugs.
The medicines
work by silencing or blocking messages that genes give to cells to make
proteins that can do harm, such as allowing cholesterol to accumulate. The
first few of these "RNA-interference" drugs recently were approved
for other conditions, and research is also targeting heart disease.
Farthest along is
inclisiran, tested in 1,561 people with heart disease from clogged arteries who
still had high LDL, the bad form of cholesterol, despite taking standard drugs.
They were given a shot of inclisiran or a dummy drug when they joined the
study, three months later and then every six months.
The drug lowered
LDL by 56% without serious side effects. More testing will show whether it also
lowers heart attacks and other problems, not just cholesterol. Inclisiran's
maker, The Medicines Company, plans to seek federal approval for it later this
year.
Two other RNA
interference drugs aim at a different target — triglycerides, another fat in
the blood that's elevated in one quarter of Americans. Treatments include very
low-fat diets, weight loss, fish oil and drugs, but doctors say more and better
therapies are needed.
Each RNA
interference drug was tested at various doses in 40 people. A single shot
lowered triglycerides by 30% to 67%, and the benefit lasted for at least four
months. The studies were just intended to show safety; Arrowhead
Pharmaceuticals is developing both drugs.
Other research
found new benefits from older drugs. AstraZeneca's Farxiga, originally
developed to treat diabetes, also lowered the risk of heart problems in heart
failure patients who did not have diabetes. Among 2,605 of such patients
treated for 18 months, about 9% of those on Farxiga had worsening heart failure
or heart-related death versus nearly 13% of those not given the drug. That
worked out to a 27% lower risk, without extra serious side effects.
Surprising
benefits also were seen in a Canadian study of the decades-old gout drug. The
anti-inflammatory drug colchicine — sold as Colcrys, Mitigare and in generic
form — was tested in 4,745 people who recently had a heart attack.
After about two
years, colchicine users had a 23% lower risk of suffering a new heart attack,
heart-related death, stroke, cardiac arrest or urgent need for an
artery-opening procedure compared with a group given dummy pills. The benefit
came mostly from preventing strokes and artery-opening procedures, and some
heart doctors would rather have seen more difference in heart attacks and
deaths.
Colchicine is
being tested in several other studies, and more evidence is needed before using
it routinely to lower heart risks, Dr. L. Kristin Newby of Duke University
wrote in a commentary published with the study in the New England Journal of
Medicine.
Dr. Donald
Lloyd-Jones, a Northwestern University cardiologist and program chief for the
heart conference, was more supportive.
"When you
have a safe drug that's easily available, it's going to be hard to hold this
one back," he said.
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