Trial finds combining 3 drugs into 1 pill cuts heart disease deaths
A large international clinical trial has found combining three common heart disease drugs into the one pill is significantly more effective at preventing cardiovascular events and death compared to administering each of the medicines separately.
The treatment tested in the new trial is called Trinomia and it’s what is known as a polypill – several different drugs all rolled into a single pill.
The idea of polypills has been around for several decades and it’s based on the suggestion that patients tend to adhere better to treatments involving single pills rather than trying to manage three or more different drug regimes. A 2018 trial that tested a polypill for hypertension, for example, was found to be more effective at managing blood pressure in patients compared to those prescribed the same three medications separately.
In the case of Trinomia, this polypill is designed for heart disease patients and combines aspirin, ramipril, and atorvastatin. To test its efficacy the researchers recruited nearly 2,500 participants across seven countries.
Participants were recruited following a heart attack and randomized into either taking Trinomia or a standard therapy involving taking each of the medicines separately. The entire cohort was followed for an average of three years.
At the end of the three-year trial the researchers found those taking the polypill were 33% less likely to die from subsequent cardiovascular events compared to those on the standard protocol. The polypill group also had a 24% lower risk of four different major cardiovascular events (such as non-fatal stroke or non-fatal heart attack) compared to those taking the three drugs separately.
“The results of the SECURE study show that for the first time that the polypill, which contains aspirin, ramipril, and atorvastatin, achieves clinically relevant reductions in the recurrent cardiovascular events among people who have recovered from a previous heart attack because of better adherence to this simplified approach with a simple polypill, rather than taking them separately as conventional,” explained Valentin Fuster, lead researcher on the trial.
The trial also confirmed the benefits of this polypill strategy are due to patients being more likely to adhere to their drug treatment. Combining several drugs into one pill meant those taking the polypill continued their treatment with greater consistency than those tasked with managing three separate medications every day.
“Although most patients initially adhere to treatment after an acute event such as an infarction, adherence drops off after the first few months,” said Fuster. “Our goal was to have an impact right from the start, and most of the patients in the study began taking a simple polypill in the first week after having a heart attack. By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent cardiovascular disease and death on a global scale.”
The new study was published in The New England Journal of Medicine.
Source: Mount Sinai