Will a 'new wonder drug’ cut heart attack risk?

Illustration of a human heart in the chest

According to media coverage, a "new" drug could cut your risk of heart attacks and cancer. We look at the research behind the headlines.

29th August 2017

Researchers have discovered that a drug not currently used for heart patients could cut the risk of a heart attack or stroke.

The study found that there was a 15 per cent reduction in the risk of a repeat heart attack among patients who took the drug canakinumab.

They were treated with the drug, which is sometimes used to treat gout (a type of arthritis) and some rare inherited auto-inflammatory conditions. The study was funded by Novartis, which makes the drug.

Participants in the study were given canakinumab once every three months, and monitored for up to four years

Participants in the study were given it once every three months, and monitored for up to four years. The trial involved 10,061 patients and was held in almost 40 countries.

Canakinumab is designed to reduce inflammation, which is one of the body's natural responses to infection or injury. But it also plays a major role in causing heart attacks and strokes. The study found that it did lower inflammation but had no effect on cholesterol - showing that inflammation is involved in the processes leading a heart attack or stroke. 

The research, presented at the European Society of Cardiology Congress in Barcelona, also found that, because of its effect on the immune system, the drug contributes to more occurrences of potentially fatal infection and sepsis (a serious condition where the immune system damages the body by an extreme response to infection).

The news coverage

The research was covered widely, including by The Sun, The Telegraph, Express, Guardian, Independent, and the BBC.

The Sun’s coverage said that this is 'being hailed the biggest medical breakthrough since statins' but does not explain who has said this. The Guardian and the Telegraph backed this up by quoting Dr Paul Ridker, the lead author of the study, who said he’d seen “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.” Although a vivid quote, it’s not exactly the same as saying this is “the biggest breakthrough since statins”.

It is also important to note that the drug was not directly compared with statins.

Many publications did not mention that canakinumab was associated with more fatal infections than the placebo

The research found that this drug reduced the risk of a repeat heart attack by 15 per cent, and the risk of lung cancer by 75 per cent. But the Sun’s coverage says that the risk of "dying from heart disease and cancer" was cut by "up to half". The use of the phrase "up to" means this statement isn't particularly clear about the size of the effect, and it doesn't obviously match up to the effects as stated in the research.

The coverage is mainly very positive about this ‘wonder drug’, but many publications did not mention that canakinumab was associated with more fatal infections than the placebo.

The Express and BBC both explained that the study was funded by Novartis, but most publications did not mention this fact. 

How good was the research?

Although the source of funding could be seen as a weakness of the research, the study was a randomised controlled trial. This is an established method to reduce bias in scientific studies - it means that the people participating in the trial are randomly allocated to either the group receiving the treatment under investigation or to the group receiving placebo treatment, who act as the "control" so that the difference the drug makes can be measured. It was also a double-blind study, so neither the participants nor the experimenters know who is receiving a particular treatment. This design makes the results less likely to be affected by bias. 

The trial involved people who had previously had a heart attack, so the results cannot necessarily be applied to people who have never had a heart attack.

The drug is given by injection once every three months. It’s not clear from the report how many doses each group received, or for how long.

The BHF view

Our Associate Medical Director, Professor Jeremy Pearson, said: “Nearly 200,000 people are hospitalised due to heart attacks every year in the UK. Cholesterol-lowering drugs like statins are given to these people to reduce their risk of another heart attack and this undoubtedly saves lives. But we know that lowering cholesterol alone is not always enough.

“These exciting and long-awaited trial results finally confirm that ongoing inflammation contributes to risk of heart disease, and lowering it could help save lives.”

 

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