For the first time, a drug has helped prevent heart attacks by curbing inflammation, a new and very different approach to lowering cholesterol, the focus for many years.
People on the drug also had surprisingly lower cancer death rates, especially from lung cancer. An anti-tumour effect is an exciting possibility, but it needs much more study because the heart experiment wasn't intended to test that.
Doctors say the results on the drug, canakinumab, open a new frontier. Many heart attacks occur in people whose cholesterol is normal and whose main risk is chronic inflammation that can lead to clogged arteries.
"We suddenly know we can address the inflammation itself, the same way we learned almost 25 years ago that we could address cholesterol. It's very exciting," said the study's leader, Dr Paul Ridker of Brigham and Women's Hospital in Boston.
Results were published by the New England Journal of Medicine and Lancet, and presented at the European Society of Cardiology conference in Barcelona, Spain. The drug's maker, Novartis, sponsored the study and Ridker consults for the company.
