Study finds cholesterol-lowering drug may prevent heart disease

Jean-Sebastien Evrard  AFP  Getty Images

A medication that takes a new approach to lowering cholesterol - and that was developed in part thanks to a key Canadian discovery - appears to cut the risk of a heart attack and other heart events by as much as 20 per cent, a large new study has found. The Medicines Company, Esperion Therapeutics, and others are spending millions of dollars to prove their drugs can safely lower LDL levels. Previous research demonstrated that evolocumab, a member of this new class of drugs, effectively reduces LDL cholesterol by approximately 60 percent.

Still, the result is gratifying for researchers hoping genomic studies will serve up new drugs.

In the second year of the study, the benefits were more pronounced, with a combined heart attack and stroke risk reduction of 33 percent.

"That's a big benefit", said Dr. Marc Sabatine, the study leader, from Brigham and Women's Hospital in Boston.

Heart disease: The forgotten killer?

For patients like Susan Goodreds, whose insurance copay for Repatha is $356 a month, it's not an easy choice.

"My first thought is that even if the drug is really effective, the price has to come down in order to offer benefit ...to the health care system", she told CTV News. "You have to make some real decisions about whether to stay on it".

The Repatha study results are being presented and discussed today at the American College of Cardiology annual meeting.

In the United Kingdom, the National Institute for Health and Care Excellence (NICE) has considered the drug for select cases only, such as patients with familial hypercholesterolaemia, a genetic condition that results in high cholesterol levels and which increases the risk of developing coronary heart disease.


Repatha's numbers look better in the trial's secondary endpoint, which looks at data from the same patients, but leaves out two adverse outcomes: hospitalization for chest pain and stenting. But the study was terminated after only two years because the placebo group was at a disadvantage and having a higher rate of cardiac events.

Called Repatha, the drug reduced the risk of heart attack, stroke or cardiovascular death by 20 percent, Amgen said in a report about a 27,564-patient trial.

Till now, with LDL, "no one was sure whether it was more like blood pressure and needed to be in range, or whether we want to eliminate it like tobacco", Levy said. Almost 10 percent of folks on Repatha had one versus more than 11 percent on the dummy drug.

As a result, insurers may balk at covering the huge cost.

The researchers hope that with more time, they can show Repatha can prevent early deaths. "I don't think so". But doctors are hopeful that the results of this major study may lead to new guidelines regarding the treatment of high-risk patients, Dr. Robin Dullaart from the University of Groningen in the Netherlands wrote in an editorial in the New England Journal of Medicine, which published the research findings.

The worldwide team, which includes researchers from Imperial College London, says the drug could provide added benefit to patients already taking statins by further reducing the levels of low-density lipoprotein (LDL) cholesterol in their blood. The two-year trial showed one heart attack or stroke was prevented for every 74 patients taking it. Most patients (81 percent) had a history of heart attack, 19 percent had suffered an ischemic stroke, which happens when a blood clot blocks an artery supplying blood to the brain, and 13 percent had symptomatic peripheral artery disease, which is when blood flow to the limbs is limited.

Shares of Amgen, Inc.

A study testing whether Praluent also lowers heart risks will wrap up later this year. But it's still unclear whether these drugs-which attempt to mimic a beneficial genetic mutation-will be the breakthrough that scientists and pharmaceutical companies had imagined.

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