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A class of drugs used to reduce inflammation can lower the risk of recurrent heart attacks, strokes and lung cancer, a study claims. The drug canakinumab can cut expensive interventions, such as bypass surgery, by more than 30 per cent, researchers said. In a trial lasting 25 years, scientists from the Brigham and Women's Hospital in the US tested whether reducing inflammation among people who have had a prior heart attack can reduce risk of another cardiovascular event in the future. They enrolled over 10,000 patients who previously had a heart attack and had persistent, elevated levels of high sensitivity C-reactive protein (hsCRP), a marker of inflammation. All patients in the trial received aggressive standard care, which included high doses of cholesterol-lowering statins. In addition, participants were randomised to receive 50, 150, or 300 milligrammes (mg) of canakinumab (or a placebo for the control group), injected once every three months. Patients were followed for up to four years. The team observed a 15 per cent reduction in risk of a cardiovascular event - including fatal or nonfatal heart attacks and strokes - for patients who received either the 150- or 300-mg dose of canakinumab. They also saw a 17 per cent reduction in a composite endpoint that included hospitalisation for unstable angina requiring urgent cardiovascular procedures. The need for expensive interventions, such as bypass surgery and angioplasty, was cut by more than 30 per cent in the trial.
Importantly, these reductions are above and beyond the reduction in risk seen after taking statins alone. No effect was observed for the lower 50-mg dose, researchers said."We found that in high-risk patients, a drug that lowers inflammation but has no effect on cholesterol reduced the risk of major adverse cardiovascular events," said Paul M Ridker, director of the Center for Cardiovascular Disease Prevention at Brigham and Women's Hospital. "For the first time, we have been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk," researchers said. "By leveraging an entirely new way to treat patients - targeting inflammation - we may be able to significantly improve outcomes for certain very high-risk populations," Ridker said. The study was published in the New England Journal of Medicine.