ICU Management & Practice, ICU Volume 13 - Issue 1 - Spring 2013
A
single dose of an investigational anti-inflammatory drug called inclacumab
significantly reduces damage to heart muscle during angioplasty, a recent
international clinical trial has found.
The study, which was led by Dr. Jean-Claude Tardif, Director of the Research Centre at the Montreal Heart Institute, affiliated with the University of Montreal, was presented at the American College of Cardiology conference, San Francisco, on 10 March.
To study the effects of the drug, Dr. Tardif and his team
administered a single dose of inclacumab to patients and then measured their
levels of troponin 1, which is a marker used clinically to diagnose heart
attack. They found that inclacumab reduced troponin l levels by 24%.
The trial involved 530 patients with myocardial infarction whose
median age was 61, and 78.9% of whom were men. Patients were randomised to
receive an infusion of inclacumab at 20 mg/kg, inclacumab at 5 mg/kg, or
placebo one to 24 hours before angioplasty.
"Inclacumab could indeed become an integral part of the
therapeutic arsenal of modern cardiology if we can reproduce these results in
subsequent studies. We could use the drug for a broader patient population, or
for all patients who present with a heart attack, but this will require further
study," explained Dr. Tardif.
Each year, approximately 35,000 coronary artery angioplasty
procedures are conducted in Canada to treat atherosclerosis, while more than
one million are conducted in the US. Atherosclerosis occurs when the arteries
are obstructed with deposits of fat (cholesterol), calcium and cellular waste,
and over time lose their elasticity and narrow, thus slowing down or blocking
blood flow. Resulting complications, such as angina, heart
attack and stroke, ultimately call the need of an angioplasty, which is a
percutaneous intervention that dilates the narrowed artery to re-establish
blood flow. However, heart tissue can become damaged during an angioplasty, and
an inflammatory cascade can lead to other complications.
Inclacumab is an antibody that blocks P-selectin, a molecule that
drives inflammation and plays an important role in vascular disease. A single
dose of inclacumab may provide benefits, stressed Dr. Tardif.