Newly FDA-approved Drug To Prevent Heart Attacks, Colchicine, has the potential to get integrated into the mainstream treatment of heart diseases.
Colchicine, used for centuries to treat gout, familial Mediterranean fever, and pericarditis, recently gained FDA approval as a new drug to prevent heart attacks, a novel approach to heart-attack prevention. While some factors, like potential side effects and emerging alternatives, may initially limit colchicine’s adoption by cardiologists, its approval underscores the growing belief in the cardiology community that inflammation plays a significant role in atherosclerosis, reducing heart attack risks.
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Traditionally, heart attack prevention has been focused on lowering LDL cholesterol using statins. Incorporating low-dose colchicine, which reduced cardiovascular risk by 31% in statin-treated patients, offers a dual approach in addressing heart attacks. Dr. Paul Ridker, from Harvard-affiliated Brigham and Women’s Hospital, advocates combining these effective risk-reduction strategies.
Cardiologists are moving toward personalized treatments for high-risk patients, going beyond statins. Medications targeting diabetes, obesity, and nonstatin cholesterol-lowering drugs are part of this approach, aiming to tailor treatments to individual risk factors.
The fundamental strategy for high-risk patients includes statins, blood pressure control, aspirin or anti-platelet drugs, smoking cessation, a healthy diet, and regular exercise. Afterwards, personalized approaches based on inflammatory risk, cholesterol levels, diabetes, and weight status determine the most suitable treatment.
Colchicine is inexpensive and generally safe, offering a practical option for many patients. However, it faces challenges, including concerns about diarrhoea associated with higher doses used for gout. Also, the lack of marketing resources for a small company like Agepha Pharma, the drug’s distributor, poses obstacles.
Nevertheless, the potential market for an anti-inflammatory agent to reduce heart risk is substantial. Approximately half of atherosclerosis patients exhibit elevated C-reactive protein levels despite intensive statin therapy, indicating a significant need for such treatments. Several companies are developing anti-inflammatory drugs for heart risk reduction.
Inflammation, often a response to arterial damage, becomes chronic in the presence of LDL cholesterol and other risk factors, contributing to the formation of artery-clogging plaques that can rupture and cause heart attacks. Colchicine and canakinumab, an antibody targeting interleukin one beta, has shown promise in inhibiting inflammation and reducing heart attack risk.
While canakinumab demonstrated significant results, it was prohibitively expensive for preventive therapy, prompting the search for an affordable alternative like colchicine. Colchicine’s effectiveness in reducing CRP levels and targeting inflammation in atherosclerosis led to its approval by the New FDA-approved Drug To Prevent Heart Attacks.
Colchicine’s market position is challenging due to competition from other risk-reduction candidates like Wegovy, GLP-1 agonists, SGLT2 inhibitors, PCSK9 inhibitors, and bempedoic acid. However, colchicine is more affordable than many alternatives, making it cost-effective.
Despite its potential benefits, cardiologists may be cautious in prescribing colchicine. It is unsuitable for all patients, especially those with kidney or liver disease. The lower approved dose mitigates some risks, but its history as an anti-inflammatory treatment raises concerns, as past drugs had adverse effects. The updated treatment guidelines recommend colchicine for very high-risk patients, citing potential interactions with other drugs and a slight increase in non-heart-related deaths.
In conclusion, colchicine’s FDA approval for cardiovascular inflammation treatment marks a significant development in heart attack prevention. While facing some hurdles, including safety concerns and competition, colchicine offers a cost-effective option for reducing heart attack risk by targeting inflammation alongside traditional preventive strategies. Cardiologists are moving toward personalized treatments to maximize heart protection for high-risk patients.
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Original Article By The Wall Street Journal: A New Way To Protect Against Heart Attacks
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