https://www.cnn.com/2022/08/26/health/polypill-lower-cardiovascular-events-wellness/index.html
Older heart disease patients who took a combination "polypill" made up of three different medications had a lower risk of major cardiovascular events, according to a new study published Friday in the New England Journal of Medicine and presented at the European Society of Cardiology Congress in Spain.
Study authors led by Dr. Valentin Fuster, director of Mount Sinai Heart in New York City and general director of the Spanish National Center for Cardiovascular Research, looked at 2,499 patients in seven European countries who had a history of type 1 myocardial infarction in the past six months and were either over the age of 75 or a minimum age of 65 with at least one risk factor, such as diabetes or mild or moderate kidney dysfunction.
Half the patients were given the polypill that contained aspirin, ramipril and atorvastatin, while others received the usual standard of care. Patients were followed for a median of three years.
The researchers found 48 cardiovascular deaths in the polypill group and 71 in the usual-care group, meaning patients who took the polypill had a relative risk reduction of 33% for cardiovascular death. The polypill was also favorable in other measures studied in the trial, such as stroke or myocardial infarction.
[...] There are some limitations to the research, including that the trial was not performed in a blinded manner and all patients were enrolled before the Covid-19 pandemic.
Journal Reference:
Jose M. Castellano, Stuart J. Pocock, Deepak L. Bhatt, et al., Polypill Strategy in Secondary Cardiovascular Prevention, NEJM, 2022. DOI: 10.1056/NEJMoa2208275
(Score: 4, Interesting) by ChrisMaple on Thursday September 01 2022, @04:36AM (2 children)
According to the CNN report, the researchers are guessing that it's effective because patients are more likely to consistently take a single pill than consistently take multiple pills.
There's so much wrong with that, from misbehavior of patients to inadequate experimental control to researchers not understanding what's happening.
Rampiril is an ACE inhibitor, and if it's anything like the ACE inhibitor lisinopril the dose has to be individualized and can vary as much as 20:1 from one patient to the next. A one-size-fits-all polypill sounds careless. Similarly, the dose of atorvastatin has to be individualized, although the range is smaller and less critical.
(Score: 3, Insightful) by rigrig on Thursday September 01 2022, @09:04AM
They pills were at least somewhat personalized:
Then again, I feel they should've included [placebo + 3 regular pills] and [3 placebos + polypill] groups.
No one remembers the singer.
(Score: 2) by Phoenix666 on Thursday September 01 2022, @03:53PM
I agree. Each of those medications has to be individualized and one patient might need one or two, but not the others. A person with blood pressure issues that rampiril might address might have no issue with cholesterol and not need atorvastatin, nor the blood-thinning effects of aspirin.
To me, this smacks of the patent shell game drug companies play when a blockbuster drug's patent is about to expire. In my Madison Avenue days I worked on a campaign for a drug called Caduet [caduet.com], that combined Lipitor and amlodipine. They formulated the combination because Lipitor's patent was about to expire and that drug constituted about 70% of Pfizer's revenue at that point; they needed to do something to continue to milk that cow. So they rolled it up with amlodipine, re-branded it as Caduet, and sent out their marketing people to convince doctors to prescribe Caduet instead of Lipitor so Pfizer could keep making the margin that kept their lights on and bonuses fat.
Washington DC delenda est.
(Score: 2) by TrentDavey on Thursday September 01 2022, @07:20PM
If you don't take the pill you have a 71/1250 or 5.7% chance a cardiovascular death.
If you do take the pill you have a 48/1250 or 3.8% chance a cardiovascular death.
To me this is more accurately stated as a 1.9% decrease in a chance of cardiovascular death.
Everybody on the pill has to deal with the side-effects with 94.3% doing it unnecessarily.
Or have I cocked something up?