Anti-inflammatory drug 'cuts heart attack risk'

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Anti-inflammatory drugs could cut the risk of heart attacks and strokes, a study of 10,000 patients has found.

A trial of the drug canakinumab could represent the biggest breakthrough in treatment since the advent of statins to lower cholesterol, authors say.

It reported a 15% reduction in the risk of a repeat heart attack.

The authors say the study could herald a “new frontier” in treatment, but others question the drug’s efficacy, side-effects and cost.

The British Heart Foundation (BHF) said the “exciting and long-awaited trial” could help save lives.

Heart attack patients are routinely given cholesterol-lowering statins and blood-thinning drugs to help reduce the risk of repeat attacks.

However, in this study, 10,000 patients who had previously had a heart attack were treated with the anti-inflammatory drug once every three months.

The trial, held in almost 40 countries, monitored the individuals for up to four years and found what researchers said were reductions in risk “above and beyond” those seen in patients who only took statins.

The results were presented at the European Society of Cardiology meeting, held in Barcelona, Spain.

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Lead author Dr Paul Ridker, of Brigham and Women’s Hospital, part of Harvard Medical School, said the study represented “a milestone in a long journey”.

He suggested the findings could “usher in a new era of therapeutics”.

“For the first time, we’ve been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk.

“This has far-reaching implications.”

Dr Ridker continued: “In my lifetime, I’ve gotten to see three broad eras of preventative cardiology.

“In the first, we recognised the importance of diet, exercise and smoking cessation. In the second, we saw the tremendous value of lipid-lowering drugs such as statins. Now, we’re cracking the door open on the third era. This is very exciting.”

Dr Ridker said the findings also indicated “the possibility of slowing the progression of certain cancers”, but further research was required.

‘Safety trade-offs’

Prof Jeremy Pearson, associate medical director at the BHF, said cholesterol-lowering drugs, such as statins, were not always enough to reduce the risk of repeat heart attacks.

“The findings suggest that existing anti-inflammatory drugs, such as canakinumab, could be given along with cholesterol-lowering drugs to treat survivors and further reduce their risk of another heart attack.”

Gary Gibbons, director of the National Heart, Lung, and Blood Institute, said the findings provided “compelling evidence”.

He called for further research into the findings.

However, writing in an editorial in the New England Journal of Medicine, Dr Robert Harrington, chair of the Stanford University School of Medicine, said the effects of the drugs could be “modest”.

He said the absolute clinical benefit of canakinumab “cannot justify” its routine use in patients “until we understand more about the efficacy and safety trade-offs, and unless a price restructuring and formal cost-effectiveness evaluation supports it.”

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