New Drugs Show Promise for Treating Your Heart Failure

One is already approved, another one nearing approval

New Treatments Emerging for Heart Failure

Nearly 6 million people in the U.S. are living with some level of heart failure – their heart is not pumping properly. Up to 50 percent of them die within five years of diagnosis. The number of patients affected by heart failure is only expected to increase in the future.

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That’s why it is good news that several new medications are providing doctors with better treatment options, now and in the near future, says W.H. Wilson Tang, MD, Director of Cleveland Clinic’s Center for Clinical Genomics and Research Director of the Section of Heart Failure at the Heart and Vascular Institute.

In April, the U.S. Food and Drug Administration approved a drug called ivabradine. Now being sold under the brand name Corlanor, the drug is the first new medicine for chronic heart failure to be approved in a decade. It works by inhibiting a so-called “funny current” of electrical conduction that directly decreases a person’s heart rate. It is designed to be used as an added therapy in patients who have a resting heart rate of at least 70 beats per minute despite already taking the highest doses of other heart rate-controlling medications, such as beta blockers.

Ivabradine was approved by the European Medicines Agency in 2005 to treat symptoms of angina and in 2012 to treat chronic heart failure. The U.S. FDA granted it priority review through a program that was created to speed up the availability to certain drugs that are designed to fill currently unmet patient needs for care for serious or life-threatening conditions, says Dr. Tang.

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Good clinical results

This approval came after a large worldwide clinical trial in which patients received standard treatment for heart failure and then either received ivabradine or a placebo on top of that. More than 6,500 patients with some problems regarding their heart’s ability to pump blood participated. The results showed that patients who received ivabradine had significantly lower rates of being hospitalized or dying from their cardiovascular problems.

Most patients who take ivabradine take one pill twice a day, with meals. The dose may need to be adjusted over time, depending on how their heart rate is affected. Bad reactions to the medicine were rare in the clinical trial. The most common ones include the heart rate becoming too slow, blood pressure becoming too high, uneven heartbeats (atrial fibrillation) and seeing flashes of light that are reversible with lowering the doses. These can be serious, and should be reported to your physician.

Second new drug

Meanwhile, another drug in development – known as LCZ696 – also looks promising for treating heart failure. LCZ696 is a combination of two existing blood-pressure-reducing medications, valsartan and sacubitril.

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A clinical trial involving over 8,400 patients showed that it also lowered the chances of death or hospitalization by about 20 percent compared to the current standard drug treatment. The findings from the clinical trial were so strong that an ethics council monitoring the trial data requested that the study end seven months early.

LCZ696 was found to have no serious side effects. It was, however, shown to have reduced the risk of death from cardiovascular causes by 20 percent, reduced rate of heart failure hospitalizations by 21 percent and reduced the risk of all-cause mortality by 16 percent, Dr. Tang says. Based on these promising results, this drug if approved is likely going to be a replacement of one of the first-line drugs in heart failure, ACE inibitors.

Despite advances in treatment during the past two decades, long-term prognosis of heart failure still is poor in patients at advanced stages. “We are excited that these new drugs, and others like them, are bringing new options to the treatment of this condition,” he says.

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