Combination ‘polypill’ reduces deaths from heart disease, study finds

One tablet combining three heart drugs significantly reduced heart-related and other deaths. heart problems in people who have had a previous heart attack, according to a new study released Friday in New England Journal of Medicine.

The results of the “polypill” were so compelling that they reduced heart disease-related deaths or additional heart disease by 24%, and the researchers plan to submit the data to the Food and Drug Administration for approval, the study said. Valentin Fuster, lead author, director of Dr. Mount Sinai Heart and chief physician at Mount Sinai Hospital in New York City, said:

“Frankly, the results were very exciting,” said Fuster, who made the presentation on Friday at the meeting of the European Society of Cardiology in Barcelona, ​​Spain.

The idea of ​​polypills to treat heart disease is not new. Researchers have spent his 20 years playing around with the idea.another study .

The lead author of the 2020 study, Dr. Salim Yusuf, a cardiologist and professor of medicine at McMaster University in Ontario, said the new study confirms that the polypill provides “substantial” benefits. Said there was

“The evidence now is overwhelming,” he said.

FDA committees have met to discuss potential risks and benefits of other versions of the polypill, but they are not yet approved in the United States. A new research pill created by Spanish pharmaceutical company Ferrer was approved for use in Europe in 2014.

In the United States, however, polypill clinical trials have not been large enough to prove the drug offers real-world benefits, said Dr. Thomas Wang, a cardiologist at UT Southwestern Medical Center in Dallas. is written as editorial It came with new research.

Another challenge is identifying the right drug combination at the right dosage for potentially widely prescribed tablets.

A seemingly one-size-fits-all approach is a dead end for some physicians. Dr. Steven Nissen, a cardiologist at his clinic in Cleveland, says health care providers should be able to individually adjust the dosage of such drugs for each patient.

Still, Nissen, who was not involved in the study, said he was intrigued by the results. I guess.

Fuster and his team looked at 50 variations of such pills to come up with the right recipe to work.

They ended up with three drugs. statin Lowers cholesterol, lowers ACE inhibitors blood pressure Aspirin, which prevents blood from clotting. All three drugs are available in generic form, which is expected to keep costs low.

But it may not be the combination of drugs within the polypill that ultimately led to the improvement. Simply put, people may be more likely to take their medication if he only has one pill instead of multiple.

People discharged from the hospital after a heart attack are usually sent home with four to five prescriptions to prevent a second heart attack.

“There’s a lot to ask people to keep track of five drugs,” he said.

After a heart attack, it’s not uncommon to lose diligence over time, even if you initially take your prescribed heart medication.

“It’s a natural human instinct to stop taking one or more medications, as the further away you are from the event, the lesser the risk somehow,” UCLA Health, Los Angeles.

By combining multiple medicines into one pill, you are less likely to miss a potentially life-saving medicine. In fact, it was the main driver of the new research results. People who were prescribed polypills were more likely to take them.

“Adherence was the single most important factor,” says Fuster. “It was really driving the results.”

Fuster’s study included 2,499 patients aged 65 and older who had previously had a heart attack.

All patients were given the same three drugs, but half were given in one tablet and the rest were prescribed in another tablet as usual.

Over the next 3 years, 12.7% of patients in the usual care group experienced a heart attack or stroke, required bypass or other procedures to restore blocked venous or arterial blood flow, or had a heart attack. 9.5% died from disease. I was given a polypill.

Side effects were similar in both groups.

Fonarow, who was not involved with the new study, called the data “excellent.”

He said the benefits of the polypill are obvious.

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