Single-dose ‘polypill’ saved lives and prevented heart attacks in major new trial

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Three-in-one drug combination may help people with a history of heart attack stay healthy, new research suggests shows. The randomized clinical trial found that people who took the bundled drug, also known as the polypill, had fewer heart attacks, strokes or cardiovascular deaths than those who received standard care. The findings could pave the way for the polypill to become a mainstream heart treatment in the future.

The basic concept of polypill has been around for more than two decades. Many medical conditions require multiple medications, which can be a time-consuming task and an additional burden on patients. So by taking these individual drugs and putting them in one pill, the theory goes, you can make it easier for patients to adhere to their treatment. There are already standard treatments for some conditions, such as HIV, that are given as combination drugs. But the original inspiration for the polypill was as a way to improve the treatment of cardiovascular disease. And now that strategy seems to have passed its biggest test yet with flying colors.

In 2015, the trial “Secondary prEvention of CardiovascUlar disease in the Elderly” – or SECURE began. It aimed to test a fixed-dose combination of three generic drugs already known to improve heart disease outcomes: aspirin, a common statin known as atorvastatin, and ramipril, an ACE inhibitor. The combination drug is manufactured by Ferrer pharmaceutical company and is approved in EU and some other countries like Trinomial.

Around 2,500 heart attack survivors aged over 65 were included in the trial, which was sponsored by the EU and conducted in seven European countries. Patients were randomized to receive Trinomia or standard treatment. They were then followed over the next five years, the researchers primarily looking for incidents of cardiovascular death, as well as non-fatal heart attacks, strokes, and blocked coronary arteries requiring urgent treatment.

In the end, 12.7% of patients in the control group experienced at least one of these results, compared to 9.5% of those in the polypill group, i.e. a 24% reduction in risk. When it comes to deaths specifically, those who took the polypill were 33% less likely to die than control patients. And other data showed that people on the polypill were more likely to continue taking it as recommended.— exactly as expected. The conclusions of the study were published Friday in the New England Journal of Medicine.

“Treatment with a polypill containing aspirin, ramipril, and atorvastatin within 6 months of myocardial infarction resulted in a significantly lower risk of major adverse cardiovascular events than usual care,” wrote the authors.

The SECURE trial is the first of its kind to test the polypill for heart attack survivors. Many experts in the field have been waiting for the results of the study, and it is this kind of benchmark data that can lead to wider acceptance of a new treatment approach in medicine. Given these results, it is likely that more countries will decide to approve Trinomia. (Notably, the United States has not approved Trinomia, although he approved other polypills.) So the drug could very well one day become a new standard of care for survivors at risk of future heart complications.

“The results of the SECURE study suggest that the polypill could be an integral part of strategies for preventing recurrent cardiovascular events in patients who have suffered a heart attack. By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent cardiovascular disease and death globally,” said study lead author Valentin Fuster, MD. head of Mount Sinai Hospital in New York. as director general of the Spanish National Center for Cardiovascular Research, in a statement published by Mount Sinai.

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