Scientists discover novel drugs to fight heart disease

There is a long list of drugs currently available that lower blood pressure and bring down cholesterol levels to reduce the chances of developing heart problems. Now, scientists are discovering novel drugs, both new and existing, that could reduce the risk of heart disease. One study found that a drug typically used to treat gout could benefit survivors of heart attacks. Besides this, several experimental drugs are being tested in the laboratory. These new drugs interfere with genes that are harmful to heart health, but they do not tamper with the genes themselves. In one instance, just twice-yearly treatment has shown benefit. The results were shared with the scientific community at a conference held in Philadelphia by the American Heart Association. “There’s a lot of excitement about the new gene-targeting medicines, especially because they seem to last so long,” says Dr. Karol Watson of the University of California, Los Angeles. Gene therapy and alterations in DNA are one of the ways scientists use to attack diseases at their root. The new medications are novel because they accomplish this without modifications in the genes. “The new drugs essentially accomplish the same thing without tampering with genes,” says Dr. Daniel Rader of the University of Pennsylvania. Dr. Rader has consulted with some of the drug manufacturers who are exploring gene therapy. The drugs work by interfering with the signaling system between genes and cells. For example, a gene may tell cells to produce a protein that is harmful to heart health because it allows cholesterol accumulation. Some such RNA-interference drugs have been approved to treat other medical conditions. Scientists are now exploring their utility in targeting heart disease. One of the drugs, inclisiran, was tested in more than 1,500 people with high cholesterol (LDL) levels and clogged arteries, unresponsive to standard treatment. The study participants received a shot of inclisiran or placebo at the start of the study, then after three months, then every six months. The results showed inclisiran lowered LDL by more than 50 percent and did not cause any serious side effects. Further testing is needed to confirm whether the effect is limited to cholesterol or the drug also affects other risk factors for heart disease. The Medicines Company, the drug manufacturer that has developed inclisiran, will be applying for federal approval shortly. Other RNA-interference drugs are being tested, including two medicines that target triglycerides, another type of fat in the blood that can clog arteries. Traditionally, high triglyceride levels are managed with a low-fat diet, fish oils, weight loss, and medications, but scientists are looking for more effective treatments. Early results are encouraging. Each of the two new gene-targeting drugs was tested in 40 people who received varying doses. A single dose was able to reduce triglyceride levels by 30 to 67 percent. Interestingly, the effects were long-lasting and benefits were noted for at least four months. The study was conducted by Arrowhead Pharmaceuticals, the manufacturer of both drugs, to demonstrate safety. Besides the new RNA-interference drugs, existing medications have been found to benefit people at risk of heart disease. The drug Farxiga from AstraZeneca was originally developed as a treatment for diabetes. However, it has shown benefit in non-diabetic patients with heart failure. The drug was given to roughly 2,600 people with heart failure for a period of 18 months. It resulted in a 27 percent lower risk of heart-related deaths and did not cause any additional serious side effects. More surprising discoveries have been made. An anti-inflammatory drug, colchicine, that has been used for decades to treat gout has shown benefit in reducing the risk of heart disease. The drug (brand names Mitigare, Colcrys) was tested in about 4,700 recent heart attack survivors. Two years of colchicine treatment was found to reduce the risk of suffering another heart attack or dying from heart attack, cardiac arrest, or stroke by 23 percent. Compared to the patients who received a dummy (placebo), the colchicine-treated patients also had a lower chance of needing urgent heart procedures to unclog arteries. Dr. L. Kristin Newby of Duke University, however, warns that further evidence is needed before colchicine can routinely be used to lower the risk of heart disease. Others are more optimistic. “When you have a safe drug that’s easily available, it’s going to be hard to hold this one back,” says Dr. Donald Lloyd-Jones, a cardiologist at Northwestern University and the program chief at the conference.