New Drugs Might Give Heart Patients an Edge
Cangrelor, Inspra and inclacumab seem to improve outcomes in company-funded trials
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The new study "shows that we do not necessarily have to pre-treat these patients, but once they get to the lab we can give them a very rapidly acting medication with rapid-onset action and rapid offset," she said.
There's one caveat, however: cost. Lead researcher Dr. Deepak Bhatta, chief of cardiology at Brigham and Women's Hospital in Boston, told reporters that cangrelor's price has not yet been set, but it likely will carry a much higher price tag than Plavix. But, he believes the cost of the drug would be offset by savings gained as patients avoid lengthy pre-surgery hospital stays, waiting for the effects of Plavix to wear off.
A second study focused on the drug eplerenone, marketed by Pfizer as Inspra. The drug is currently FDA-approved to help lower high blood pressure and to ward off heart failure after heart attack. In the new Pfizer-funded trial, slightly more than 1,000 patients who had had a heart attack caused by complete blockage of an artery took either Inspra or a placebo in addition to standard treatments.
Patients were followed for an average of a bit more than 10 months. Researchers led by Dr. Gilles Montalescot of the Pitie-Salpetriere Hospital in Paris reported that those taking Inspra were 38 percent less likely than those on a placebo to have outcomes such as death by cardiovascular causes, rehospitalization due to heart failure, irregular heart rhythms or other indicators of heart failure.
Commenting on the results at a news conference, Dr. Miguel Quinones, chair of cardiology at Methodist DeBakey Heart and Vascular Center in Houston, said the study showed a "striking" short-term benefit for patients, but it's unclear if it would be sustained over time. Use of Inspra could be "a game-changer if we could demonstrate three to five years later that we have significantly improved outcomes," he said.
A third and smaller trial, published simultaneously online in the Journal of the American College of Cardiology, looked at another still-unapproved drug, the anti-inflammatory agent inclacumab, for use in patients undergoing angioplasty.
The ACC noted that more than 1 million Americans each year undergo angioplasty. But angioplasty can also trigger damage to heart tissues, and it was thought that the new drug might help minimize that risk.
In the study, which involved 322 patients with a common form of heart attack, participants got either various doses of inclacumab or a placebo about an hour before their angioplasty.
The research team assessed changes in levels of troponin I -- a protein found in the blood that indicates heart damage -- as a means of telling whether the drug was effective or not.
The researchers reported that 24 hours after the procedure, patients who had gotten the highest dose of inclacumab saw their troponin I levels drop by more than 24 percent compared to those on a placebo -- indicating less heart tissue damage. Levels of another marker of heart tissue damage, called CK-MB, fell by more than 17 percent over 24 hours compared to placebo, the team added.