Choles­terol drug shows promise to help re­verse heart dis­ease

Kuwait Times - - HEALTH & SCIENCE -

NEW OR­LEANS: For the first time, a new drug given along with a choles­terol-low­er­ing statin medicine has proved able to shrink plaque that is clog­ging ar­ter­ies, po­ten­tially giv­ing a way to undo some of the dam­age of heart dis­ease.

The dif­fer­ence was very small but doc­tors hope it will grow with longer treat­ment, and any re­ver­sal or sta­bi­liza­tion of dis­ease would be a win for pa­tients and a long-sought goal. The drug, Am­gen Inc.’s Repatha, also drove LDL, or bad choles­terol, down to lev­els rarely if ever seen in peo­ple be­fore. Heart pa­tients are told to aim for be­low 70, but some study par­tic­i­pants got as low as 15. “There doesn’t ap­pear to be any level at which there is harm” from too lit­tle LDL, and the lower pa­tients went, the more their plaque shrank, said one study leader, the Cleve­land Clinic’s Dr. Steven Nis­sen.

Re­sults were pub­lished Tues­day by the Jour­nal of the Amer­i­can Med­i­cal As­so­ci­a­tion and dis­cussed at an Amer­i­can Heart As­so­ci­a­tion con­fer­ence. Statins such as Lip­i­tor and Crestor curb choles­terol pro­duc­tion. Repatha and a sim­i­lar drug, Pralu­ent, block PCSK9, a sub­stance that in­ter­feres with the liver’s abil­ity to re­move choles­terol from the blood. Too much choles­terol, along with other sub­stances, can build up and form plaque in ar­ter­ies.

Draw­backs

The new drugs have draw­backs, though. Statins are pills sold as gener­ics for as lit­tle as a dime a day. The new ones are biotech drugs that are ex­pen­sive to make - Repatha costs $14,000 a year and in­sur­ers of­ten won’t pay. They must be given as shots ev­ery two weeks or once a month. Peo­ple can do it them­selves with a pen like de­vice.

In the study, about 900 heart dis­ease pa­tients were given a strong statin and monthly shots of ei­ther Repatha or a dummy so­lu­tion. Ul­tra­sound im­ages were taken of an artery with plaque at the start of the trial and 18 months later. The av­er­age for bad choles­terol stayed around 93 for peo­ple given only the statin, but dropped to 37 for those on both drugs. The amount of artery plaque stayed about the same for the statin-only group but shrank 1 per­cent in those also given Repatha. Some peo­ple with more dra­matic LDL de­clines saw plaque shrink 2 per­cent. “It’s small, but it prob­a­bly took pa­tients 60 years to ac­cu­mu­late that plaque,” so to see any change after just 18 months of treat­ment is good, said a choles­terol ex­pert, Dr. Raul San­tos of the Univer­sity of Sao Paolo.

— AP

NEW OR­LEANS: This un­dated image pro­vided by Am­gen Inc. shows the choles­terol-low­er­ing drug Repatha.

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