The novel polypill called Trinomia contains aspirin, simvastatin, and ramipril. Credit: Mount Sinai
Key Points:
- A team of doctors have created a “polypill” that contains three drugs commonly given after a heart attack in a single pill.
- The “polypill,” to be sold as Trinomia, makes it easier for patients to take all three drugs, and was found to reduce post-heart attack mortality rates by 33%.
Doctors at the Spanish National Center for Cardiovascular Research (CNIC) and Ferrer have created a straightforward solution to help patients who have suffered from heart attacks. Their brainchild—a “polypill” that administers three drugs concurrently—was found to reduce deaths from cardiovascular complications after a heart attack by 33%. The doctors published their study in The New England Journal of Medicine.
Three types of drugs are often used to support a patient’s cardiovascular system after a heart attack. The regimen’s effectiveness, however, depends on a patient’s ability to take all three drugs throughout the treatment’s course. Unfortunately, statistics show patient compliance drops to less than 50% just months after starting the regimen.
The “polypill,” to be sold as Trinomia, combines aspirin, ramipril and atorvastatin in a single pill. CNIC scientists first demonstrated that the polypill significantly improved treatment adherence among patients recovering after a myocardial infarction, in the FOCUS study, published in the Journal of the American College of Cardiology (JACC).
The CNIC team then launched the SECURE study, an international randomized clinical trial, to determine whether the improved treatment adherence with the polypill translated into a reduction in cardiovascular events.
SECURE included 2,499 patients from seven European countries recovering after a heart attack. Researchers analyzed the incidence of four major cardiovascular events: death from cardiovascular causes, non-fatal myocardial infarction, non-fatal stroke, and need for emergency coronary revascularization. The study followed patients for an average of three years and produced conclusive results: patients taking the CNIC polypills had a 24% lower risk of these four events than patients taking the three separate drugs.
But, the standout finding of the study, according to the researchers, is the effect of the polypill on the key outcome of cardiovascular-related death—which showed a relative reduction of 33 percent from 71 patients in the group receiving standard treatment compared with just 48 in the polypill group. Importantly, the study found that patients in the polypill group had a higher level of treatment adherence than those in the control group.
“The SECURE study findings suggest that the polypill could become an integral element of strategies to prevent recurrent cardiovascular events in patients who have had a heart attack. By simplifying treatment and improving adherence, this approach has the potential to reduce the risk of recurrent cardiovascular disease and death on a global scale,” said SECURE trial lead Valentin Fuster, MD, PhD, Director of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, and General Director of CNIC.