A new anti-inflammatory drug developed by pharmaceutical giant Novartis has doctors optimistic about the future of preventing heart attacks and improving cardiovascular health.
A study published late last month in The New England Journal of Medicine examined the effects of a series of injections of anti-inflammatory drug canakinumab on 10,000 study participants. The findings of that study suggest proof of concept for a long-standing hypothesis: that inflammation in the heart’s arteries may be a potential cause of cardiovascular disease, events and death, independent of high cholesterol and the deadly plaque it causes.
Certainly, the findings as reported suggest there’s good reason for optimism, namely the 15 percent reduction in subsequent cardiovascular events and 30 percent reduction in traumatic surgeries including stent placement and bypass procedures. For people at risk of heart disease, that’s good news. And really, who isn’t at risk? Heart disease, stroke, and heart attacks account for roughly a quarter of all deaths in the U.S. each year, especially once you hit 40. If you’re not 40 yet, no worries. You will be some day, and then you’ll wish you’d exercised and ate less crappy stuff back when it was much easier. But I digress.
The Canakinumab Antiinflammatory Thrombosis Outcome Study, or CANTOS, which is much easier to say, was performed out of Boston’s Brigham and Women’s hospital and helmed by Dr. Paul Ridker. The 10,000 study participants had a history of myocardial infarctions and a high level of a certain protein that indicates inflammation in the body, and patients with conditions that might otherwise cause an increase in that protein were controlled for and ineligible to participate.
The group was then given either the canakinumab or a placebo over the course of four years, and the results show that the drug was able to neutralize the inflammatory protein without touching the cholesterol level much better than the placebo could.
Why is all of this important? Well, we’ve made a lot of big strides in preventative cardiovascular health. We know that diet and exercise are crucial to maintaining heart health, and reducing the risk of cardiac event and stroke because it keeps LDL cholesterol in check.
But what happens when diet and exercise don’t reduce the level of LDL cholesterol enough? We use statins, a class of drugs that can help reduce it. But what happens when the statins don’t work? Well, that’s where canakinumab comes in. It may not be a complete therapy yet, but now we know that it has real potential to be one, especially since it seems highly likely that inflammation can be as serious a culprit of cardiovascular conditions as cholesterol is.
In a statement on Brigham and Women’s website, Dr. Ridker expressed his excitement for the future of therapies that focus on reducing inflammation, calling it the “third era” of preventative care in matters of the heart.
“In my lifetime, I’ve gotten to see three broad eras of preventative cardiology. In the first, we recognized 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,” said Ridker. “This is very exciting.”