New Combo Drug Cuts Heart Attacks In Half

[Nokoni]

Overview here:
Heart attacks halved by daily 'polypill', strokes reduced too: study

Study here:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31791-X/fulltext

"A fixed-dose combination therapy (polypill strategy) has been proposed as an approach to reduce the burden of cardiovascular disease, especially in low-income and middle-income countries (LMICs). The PolyIran study aimed to assess the effectiveness and safety of a four-component polypill including aspirin, atorvastatin, hydrochlorothiazide, and either enalapril or valsartan for primary and secondary prevention of cardiovascular disease."

(The aspirin dose was a baby aspirin, 81 mg. Atorvastatin (Lipitor) is a cholesterol reducing drug, hydrochlorothiazide is a diuretic, enalapril is an ACE inhibitor, and valsartan is an angiotensin receptor blocker.)

Too bad they didn't have an arm of the study take just aspirin.

 

[schultz]

Too bad they didn't have an arm of the study take just aspirin.

Yah that would have been interesting.

 

[Nokoni]

Yah that would have been interesting.

Better yet, two additional arms. One with just the baby aspirin, the other with just one adult aspirin. My guess would be that adult aspirin > baby aspirin > combo pill.

 

[aguineapig]

They just wanted to piggy back on the efficacy of the aspirin most likely. Scoundrels....

 

[aguilaroja]

Heart attacks halved by daily 'polypill', strokes reduced too: study

(The aspirin dose was a baby aspirin, 81 mg. Atorvastatin (Lipitor) is a cholesterol reducing drug, hydrochlorothiazide is a diuretic, enalapril is an ACE inhibitor, and valsartan is an angiotensin receptor blocker.)
...they didn't have an arm of the study take just aspirin.

Physicians have been floating this "polypill" dangerous fantasy for decades. There are too many dangerous, unintelligent and corrupt mixed ideas to fully list. Here are some of the fallacies:

First: What if everyone could be treated the same way, ignoring context and individual situation.
Second: It is better if the same one thing is done every time, so neither the patient nor the doctor has to think.
Third: Let's give everyone a statin, so health is a statin deficiency and high blood cholesterol is the problem
Fourth: High blood pressure is a "disease" (not an associated condition) and it usually requires multiple pharmaceuticals to "manage".

The polypill fantasy started when the three non-aspirin ingredients were still under patent. Aspirin was a bystander, because it had accumulated evidence while being off-patent. The prospects for three extra patented medications given lifetime to every adult would mint money for pharmaceutical companies.

Even now, any "polypill" single "formula" combination could be patented. This re-packaging of generic medications could extend patent rights for any one formula. It is easy to see what happens next: Drug companies spend the next thirty years tweaking individual combinations to argue that theirs is best. The result is inflated prices for cheap ingredients until mid-century.

There is no deep idea behind poly-pills. It re-packages nonsense about statins, "bad cholesterol" and pharmaceutical blood pressure lowering. There is no revision about thinking about heart, blood vessels and health. Forum readers know about the dangers of statins. Read the side effects of the other two drugs.

Also, looking briefly at the study, there was NO comparison with placebo pills. There were only a minimal treatment group and a polypill group. There was a long list of exclusion categories for subjects, including depression, asthma, rhinitis, and more.
The full paper does not give indication of tracking groups for polypill side effects, other than switching polypill types for the known coughing side-effect of enalopril.

The NON-cardiac death rate was HIGHER in the polypill group. This at least suggests there are polypill hazards.

Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases. - PubMed - NCBI
The effects of fixed-dose combination therapy on all-cause mortality or ASCVD events are uncertain. A limited number of trials reported these outcomes, and the included trials were primarily designed to observe changes in ASCVD risk factor levels rather than clinical events, which may partially explain the observed differences in risk factors that were not translated into differences in clinical outcomes among the included trials. Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo, active comparator, or usual care but may be associated with improved adherence to a multidrug regimen.

Impact of blood pressure lowering, cholesterol lowering and their combination in Asians and non-Asians in those without cardiovascular disease: an ... - PubMed - NCBI
"Candesartan/hydrochlorothiazide had fewer effects in reducing blood pressure in Chinese and rosuvastatin reduced low-density lipoprotein cholesterol to a lesser extent in Asians compared with non-Asians. There was no overall reduction in clinical events with lowering blood pressure in either Asians or non-Asians,..."

 

[Nokoni]

They just wanted to piggy back on the efficacy of the aspirin most likely. Scoundrels....

No doubt

 

[Nokoni]

Physicians have been floating this "polypill" dangerous fantasy for decades. There are too many dangerous, unintelligent and corrupt mixed ideas to fully list. Here are some of the fallacies:

First: What if everyone could be treated the same way, ignoring context and individual situation.
Second: It is better if the same one thing is done every time, so neither the patient nor the doctor has to think.
Third: Let's give everyone a statin, so health is a statin deficiency and high blood cholesterol is the problem
Fourth: High blood pressure is a "disease" (not an associated condition) and it usually requires multiple pharmaceuticals to "manage".

The polypill fantasy started when the three non-aspirin ingredients were still under patent. Aspirin was a bystander, because it had accumulated evidence while being off-patent. The prospects for three extra patented medications given lifetime to every adult would mint money for pharmaceutical companies.

Even now, any "polypill" single "formula" combination could be patented. This re-packaging of generic medications could extend patent rights for any one formula. It is easy to see what happens next: Drug companies spend the next thirty years tweaking individual combinations to argue that theirs is best. The result is inflated prices for cheap ingredients until mid-century.

There is no deep idea behind poly-pills. It re-packages nonsense about statins, "bad cholesterol" and pharmaceutical blood pressure lowering. There is no revision about thinking about heart, blood vessels and health. Forum readers know about the dangers of statins. Read the side effects of the other two drugs.

Also, looking briefly at the study, there was NO comparison with placebo pills. There were only a minimal treatment group and a polypill group. There was a long list of exclusion categories for subjects, including depression, asthma, rhinitis, and more.
The full paper does not give indication of tracking groups for polypill side effects, other than switching polypill types for the known coughing side-effect of enalopril.

The NON-cardiac death rate was HIGHER in the polypill group. This at least suggests there are polypill hazards.

Fixed-dose combination therapy for the prevention of atherosclerotic cardiovascular diseases. - PubMed - NCBI
The effects of fixed-dose combination therapy on all-cause mortality or ASCVD events are uncertain. A limited number of trials reported these outcomes, and the included trials were primarily designed to observe changes in ASCVD risk factor levels rather than clinical events, which may partially explain the observed differences in risk factors that were not translated into differences in clinical outcomes among the included trials. Fixed-dose combination therapy is associated with modest increases in adverse events compared with placebo, active comparator, or usual care but may be associated with improved adherence to a multidrug regimen.

Impact of blood pressure lowering, cholesterol lowering and their combination in Asians and non-Asians in those without cardiovascular disease: an ... - PubMed - NCBI
"Candesartan/hydrochlorothiazide had fewer effects in reducing blood pressure in Chinese and rosuvastatin reduced low-density lipoprotein cholesterol to a lesser extent in Asians compared with non-Asians. There was no overall reduction in clinical events with lowering blood pressure in either Asians or non-Asians,..."

The scam never ends.