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Abu Dhabi, UAETuesday 25 September 2018

'Superdrug' offers hope in fight against heart attacks and cancer

Successful trials of canakinumab reduce repeat heart attacks by a quarter in study of 10,000 patients

It could be a game changer in the treatment of those at risk from heart disease and has been described by doctors as the biggest development in the field since statins.

Just four injections a year of the drug canakinumab could slash repeat heart attacks by 25 per cent — almost double the success rate of statins, a group of drugs commonly used to lower cholesterol.

Results from a landmark study of more than 10,000 patients over four years by Harvard Medical School have been published in the New England Journal of Medicine.

Doctors found anti-inflammatory drug canakinumab was effective in protecting the body against a variety of health conditions, and also helped reduce cancer deaths.

Those given the treatment saw a 24 per cent reduction in heart attacks and a 17 per cent fall in angina — chest pain.

Abu Dhabi doctors said the results are positive, and could provide a viable treatment for young people who have had a heart attack, and an alternative to long term use of statins that can have side effects.

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“We know this drug is effective in reducing inflammation and it has a similar affect to statins,” said Dr Tarig Elhassan, a specialist in cardiac surgery at Burjeel Hospital.

“This prevents blood from clotting. We know high doses of statins can cause complications and side effects, such as a bone weakness or osteoporosis in women.

“This recent study shows it could be effective in those who have heart attacks that may not have been a result of high cholesterol, for which statins are often used, but more a kind of inflammation that occurs between the three layers of the arteries.”

It was not just heart conditions that showed signs of success, as cancer deaths also decreased by 51 per cent in those prescribed the highest dose of medication.

The treatment works by blocking part of the immune system, and reducing inflammation which is the body’s natural response to infection or injury.

Doctors said a high level of inflammation is associated with a range of health conditions related to cancer, osteoarthritis and rheumatoid arthritis, and is also a factor in causing heart attacks and strokes.

Statins have been widely hailed as a life changing ‘superdrug’ by some health experts, who claim it helps millions live with chronic life-changing conditions and can reduce the risk of stroke or heart attack by up to 35 per cent in some patients.

Despite the success of trials, one stumbling block in the way of widespread use of canakinumab is cost.

Whilst statins are relatively cheap, costing from Dh45 a month for unbranded medication, the new treatment costs about Dh190,000 for an annual course of drugs.

“It is a development, but the big problem seems to be the price,” Dr Elhassan said.

“The price is beyond the imagination, but it is still in phase three of research so let’s see what happens once it is released into a bigger market.

“Once there are more patients, trials and studies done, the price may come down.

“International governments and the World Health Organisation need to apply some pressure to try and get this research done, and to reduce the price.

“We have to prove it is safe, and there has been no problems after long term use,” he said.

Abu Dhabi has high rates of chronic diseases related to lifestyle, such as obesity, diabetes, and cardiovascular diseases, with rates set to increase further as the young population ages.

Cardiovascular diseases (CVD) accounted for 34.9 per cent of all death cases in 2015. A screening programme for cardiovascular risk factors for all adult nationals was initiated in 2008 as part of enrolment in Thiqa insurance.

Individuals thought to be at high risk are being followed up.

Health Authority Abu Dhabi has also conducted extensive education and awareness campaigns on risk factors, such as smoking, physical inactivity and unhealthy nutrition.

Annual screening programmes are conducted to help control CVD.

Drugs go through many stages of research, so it could be some time before it is commonly available, maybe 10 years.

The latest clinical trials have been conducted by Novartis, the company that is producing the drug ahead of further tests to see how the drug can protect against cancer.

Dr Paul Stanley, a cardiologist at NMC Hospitals said other injectable drugs are already available that have a similar effect to statins.

“Statins are our main drug in treating cardiac disease,” he said.

“They are safe and have been used for years, but some people can have side effects. In this case an alternative is already available, Praluent, with a similar effect for patients.

“It is expensive, about Dh3,000 a month for four injections, but useful if patients cannot tolerate statins or achieve correct cholesterol levels.”

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