In late August, Daily Mail has published an article of a study carry out mainly by John McMurray and Milton Packer. It was presented in the European Congress of Cardiology in Barcelona, on August 30th. This research deals about the HF (Heart Failure) which is a physiological state that occurs when the heart is unable to pump sufficiently to maintain blood flow to meet the needs of the body, it occurs when the fraction ejection is less than 40% (a healthy left ventricle expels blood in valuables above 50%). This problem increases venous pressure and makes the body retain fluids. The investigation lasted 27 months and was performed in more than 8000 patients; in the trial patients were given either 200mg of LCZ696 (new medicine) twice daily (in addition to Enalapril) or only 10mg of Enalapril (current medicament) twice daily – in addition to the recommended treatment – in a bid to compare mortality and hospitalization rates.
Enalapril (C20H28N2O5) is the normal medicament for HF and for hypertension. It is in a class of drugs called ACE inhibitors (angiotensin-converting enzyme). Enalapril works by blocking an enzyme in the body required to cause blood vessels to narrow (constrict). As a result, the blood vessels relax. This lowers blood pressure and increases the supply of blood and it makes the heart more efficient. In the other hand LCZ696 blocks AT1 (an angiotesin receptor, it has vasopressor effects and regulates aldosterone secretion) and thereby causes vasodilation and increases excretion of sodium and water by kidneys. The primary endpoint consists in reduce cardiovascular deaths or hospitalization by this injury. Enalapril reduces the hospitalizations or deaths by a 18%. LCZ696 in addition to Enalapril doubles the effect of only Enalapril, that means that there is a reduction of 20% on top of 18%, it signifies that in a group of 21 patients a patient else will get the primary endpoint. This is not the only advantage, something really important is to improve quality of life (less renal injury, less secondary effects…), that means that they feel better with the LCZ696.
Despite the explained before, there are also articles which question the effectiveness of the new treatment. One of the most common is the one which indicates that the biggest beneficiary would be the pharmaceutical company that distributes the drug, because we are talking about a common disease in world’s population, so there is pharmaceutical interest (mainly economical) in develop alternative medicament although the health improvement won’t be too high, that means that even though that the decrease in primary endpoint was proved the pharmaceutical company will try that people perceive an even greater improvement. Other articles, without question the effectiveness in the new drug, indicate that personal factors should be taken into account before decide which kind of treatment will be applied to the patient, in brief, there will be some patients who will be more effective the use of the new drug, and there will be others which will be continue giving their old prescription.
The new drug’s company pretends to get license next year, so the product would be available in 2015.
Original source: The differences between original and popular article are easy to see. First one has more specialized words and second one is easy to understand. Other big difference is the lacks on second one, especially in the explanation of the process, which is something understandable enough to write in this kind of article.
Personal opinion: I chose this article because I thought it was a really interesting thing because the HF it’s becoming in one of the mainly problems of public health in our environment countries and its incidence is increasing with aging. Currently cardiovascular problems are the main cause of death, so I thought that many people will be interested in this new treatment. Also at late October will take place the National Congress of Cardiology in Santiago de Compostela. This new treatment may be the leading topic.