Hello Health Rounds readers! Today we feature data from two studies presented at major medical meetings that hold the promise of practice changing benefits in heart and liver disease. The first tested a drug from a new class of blood thinners that appears to be much safer than widely-used stroke preventers. The second showcases an experimental weight-loss drug that reduced liver fat in patients with early stage fatty liver disease. A third study out of Canada found significant benefits from genetic testing before prescribing antidepressants.
An experimental weight-loss drug that cleared early-stage fatty liver disease in patients with obesity has the potential to become the first approved treatment for the disease. Scroll down to learn more about it. REUTERS/Lucas Jackson
New stroke-prevention drug appears safer
A new class of blood thinners being tested for stroke prevention in late-stage trials may prove to be much safer for patients than current widely used blood clot preventers, according to trial data from one of the experimental medicines.
In a safety trial involving more than 1,200 people at increased risk of stroke due to the heart rhythm disorder atrial fibrillation, researchers compared rates of bleeding episodes during treatment with monthly injections of abelacimab being developed by Anthos Therapeutics with Bayer’s daily pill Xarelto (rivaroxaban).
Abelacimab was so clearly superior to rivaroxaban that investigators stopped the trial earlier than originally planned.
Overall, bleeding was reduced by more than 60% in the abelacimab group, they reported on Sunday at the American Heart Association Scientific Sessions in Philadelphia.
At the most effective dose, abelacimab reduced major bleeding requiring hospitalization by 81% compared to rivaroxaban, the researchers found.
Rivaroxaban and similar drugs, such as big-selling Eliquis (apixaban) from Bristol Myers Squibb and Pfizer, work by inhibiting a protein called Factor Xa that helps the body form blood clots. Abelacimab inhibits Factor XI, a protein that plays a role in the body’s ability to form clots that cause strokes but not its ability to form clots that control bleeding from blood vessel injuries.
The current trial was not designed to test the effectiveness of abelacimab at preventing stroke.
“Assuming the data from ongoing (large, late-stage) trials confirm the benefit of factor XI inhibitors for stroke prevention in people with atrial fibrillation, it will really be transformative for the field of cardiology,” study leader Dr. Christian Ruff of Brigham and Women’s Hospital in Boston said in a statement.
Read more about Factor XI inhibitors on Reuters.com
New drug may resolve early-stage fatty liver disease
Nearly 9 in 10 obese adults with early-stage fatty liver disease in a trial testing Eli Lilly’s experimental weight-loss drug retatrutide had their liver fat reduced to the point where they would no longer be classified as having the disease, according to data presented at a medical meeting.
“The implications of this trial are, we could wipe out the fat very early in the course of this disease before it becomes a real threat to the liver, and potentially reduce the long-term cardiac, metabolic, renal, and liver-related harm from obesity,” study leader Dr. Arun Sanyal of Virginia Commonwealth University in Richmond said in a statement.
The 98 study volunteers were participating in a larger trial testing various doses of retatrutide for treating obesity. The data was presented on Monday at the American Association for the Study of Liver Diseasesannual meeting in Boston.
All of them had so-called metabolic dysfunction-associated steatotic liver disease (MASLD), in which fat accounts for 5% or more of liver weight.
When the study began, everyone had a liver fat content of at least 10%. By week 48, liver fat content had dropped below 5% in more than 85% of the patients.
More than 3 million cases of MASLD are diagnosed per year in the United States alone, and the condition is one of the major causes of end-stage liver disease and liver transplantation.
Many companies have tried and failed to come up with an effective treatment for the disease formerly known as NASH (nonalcoholic steatohepatitis).
Liver fat reductions in the study were related to reductions in body weight, waist circumference, abdominal fat, and improvements in insulin sensitivity, and blood levels of cholesterol and other lipids, the researchers reported.
“We are encouraged by these results and how they can potentially help tackle a disease that is currently without any approved therapies,” Sanyal said.
Read more about experimental fatty-liver drugs on Reuters.com
Genetic testing of patients with moderate to severe depression would help identify the antidepressant drugs most likely to be effective, sparing them from having to try multiple different medications before finding one that works, according to researchers in Canada.
The benefit of such an approach “could be enormous, including increased remission rates and better quality of life, while generating significant cost savings by keeping people out of hospitals and more intensive treatment pathways,” study leader Stirling Bryan of the University of British Columbia (UBC) said in a statement.
Previous studies have shown that up to 42% of the variation in how patients respond to antidepressants is due to genetic factors, according to the researchers.
A new study, published on Tuesday in CMAJ, estimated that in the province of British Columbia, over a period of 20 years, using so-called pharmacogenomic testing to find the right medicine would be associated with 37% fewer patients having depression that wasn’t responding to treatment. The test typically involves a cheek swab or a blood test or saliva sample.
Pharmacogenomic-guided care could also save the provincial public health system about $956 million over 20 years, the researchers estimated.
“Genes play an important role in how our bodies metabolize different antidepressants, which ultimately influences their efficacy,” said coauthor Dr. Jehannine Austin, also of UBC.
“The genetic insights provided by pharmacogenomic testing can help physicians make more informed treatment decisions and reduce the lengthy trial-and-error process that many patients experience in finding an effective medication,” Austin said.