What is considered the biggest breakthrough since the discovery of statins, results from a new study has found anti-inflammatory injections to be helpful in preventing heart attacks by lowering inflammation. The drug called canakinumab (can-uh-KIN-yoo-mab), looks to be one of opening an alternative frontier ushering in a new era of therapeutics for treating heart disease. Results were published in the New England Journal of Medicine and Lancet, and presented at the European Society of Cardiology conference in Barcelona, Spain.
Statins treatment of heart disease
In the arena of preventative cardiology, statins such as Lipitor are a class of lipid-lowering medication which work primarily by lowering LDL or bad cholesterol. They have been considered a major discovery in their huge impact on reducing cardiovascular disease (CVD) and mortality in those who are at high-risk. They are particularly effective in treating CVD in the early stages of the disease and in those at elevated risk but without CVD. The only problem is up to one-fourth of people who have one heart attack will go on to have another within five years even if they are taking a statin regularly. This is believed to be due to unchecked inflammation within the heart’s arteries.
It is known that when a joint is injured or swells it is due to inflammation. But our bodies can experience similar chemical responses from inflammation over time related to unhealthy lifestyle habits. When inflammation is chronic or long-term, this sets the stage for damaged arteries and blood clots leading to a heart attack or stroke. A blood test called high-sensitivity C-reactive protein, or CRP can determine if a person has inflammation.
Groundbreaking study addresses inflammation
This new study, which lasted for four years, enrolled over 10,000 people who were heart attack survivors with low cholesterol but who had a positive blood test for inflammation or high CRP. Every patient received high doses of statins along with either three doses of canakinumab or a placebo. Both canakinumab and the placebo were given by injection every three months.
Results of study
The individuals receiving the medium dose of canakinumab had a 15% reduction in fatal and non-fatal heart attacks and strokes over the next four years compared to those receiving the placebo. This led to a 30% reduction for the need of costly interventional procedures such as bypass surgery and inserting stents. Death rates between patients on canakinumab and patients given placebo injections showed no difference. Canakinumab also did not change cholesterol levels.
A downside of canakinumab was that it increased the risk of causing a fatal injection of about 1 out of every 1,000 patients treated with older adults and people with diabetes being the most vulnerable.
Possibility of anti-cancer effect from canakinumab
A driver of the spread of cancer can be inflammation. An important discovery was patients from the study who were given injections of canakinumab had only half the death rate from cancer as those receiving the placebo. In fact, an interesting side effect of canakinumab was that dying from lung cancer was reduced by over 75% which is not yet understood by the researchers why. Future trials are planned to research canakinumab’s potential protective effect against cancer.
Scientists do not believe that canakinumab prevents new cancer from developing but that it might slow the growth of tumors that have already begun.
What this study shows is that inflammation is a contributor to increasing the risk of heart disease and that when it is lowered, it can save lives. This is great news since heart disease remains the leading killer of Americans. Any new treatments that show promise for fighting CVD is always welcomed news.