Analysis – Doctors Worry As Heart Drug Research Loses Steam

A plastinated human heart is on display at the European Society of Cardiology meeting venue in Amsterdam September 2, 2013. REUTERS/Cris Toala Olivares

Credit: Reuters/Cris Toala Olivares By Ben Hirschler AMSTERDAM | Tue Sep 3, 2013 9:42am BST AMSTERDAM (Reuters) – The hunt for new heart drugs is losing momentum as resources are switched to other areas, notably cancer research, where investors get a better bang for their buck. Cardiologists fear the fight against heart disease could stall as a result, following major advances in recent decades marked by the advent of drugs to fight cholesterol, lower blood pressure and prevent dangerous blood clots. The disparity between advances in cancer and heart medicines is already stark. Since the start of 2012, 17 new drugs been approved by the U.S. Food and Drug Administration for cancer compared with just three for heart disease. “There is a clear move of R&D from cardiovascular to cancer and other areas,” said Michel Komajda, a heart specialist at Pitie-Salpetriere Hospital in Paris and a former president of the European Society of Cardiology (ESC). Komajda, like many of his colleagues gathered at the annual ESC congress this week in Amsterdam, is worried. Despite the giant manufacturers’ stands touting heart medicines at this week’s meeting of some 30,000 doctors, investment in cardiovascular medicine is ebbing – prompting calls for an urgent rebalancing of research priorities. “There is a view among some that because we have already made a lot of progress in cardiovascular medicine then maybe it doesn’t make sense to invest anymore,” Komajda said. “But there are still some big areas where we need progress, including acute heart failure, which is a growing problem because of an ageing population.” To some extent, cardiology is a victim of its own success. By any measure, the global war on heart disease to date has been a success, thanks not only to better drugs but also prevention strategies such as anti-smoking campaigns. In Europe, the death rate from cardiovascular disease has halved over the past 30 years, while the risk of dying within 30 days of a heart attack has been cut by more than half in just 20 years. NO.1 KILLER Yet cardiovascular disease remains the number one killer worldwide and doctors fear a renewed epidemic of heart problems in 20 to 30 years time as a new generation of overweight and obese youngsters reaches middle age. “It’s a huge concern,” said Patrick O’Gara of Boston’s Brigham and Women’s Hospital, who is also president-elect of the American College of Cardiology.

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Placebos Prescribed By More Than Three-Quarters Of UK Doctors, Survey Finds

Nearly all of the doctors 97 percent reported having used some kind of placebo treatment at least once, while 12 percent reported having used a fake pill. About 77 percent of doctors said they used some kind of placebo treatment every week; more than 80 percent of them said their use in some circumstances was ethical. The “placebo effect” treatments included unnecessary physical exams, joint injections, physical therapy, peppermint pills for a sore throat and antibiotics for infections where they would not be effective. Dr. Tony Calland, chairman of the British Medical Association’s Ethics Committee, said he was disappointed by the findings. “Prescribing something that you know is of no value is not ethical,” he said. A previous study found about half of U.S. doctors regularly give their patients treatments that probably won’t work without telling them, and the practice has been reported elsewhere, including Canada, Denmark and Switzerland. The American Medical Association says physicians may only use placebos if the patient is aware. In 2011, the German Medical Association recommended doctors use fake pills and other placebo treatments more often and said patients didn’t necessarily need to be told. Some small studies have found dummy pills work even when patients are explicitly told what they’re getting and others have documented the fake treatments can spark a biological effect in the body. “For illnesses where there is no truly effective treatment, a placebo or alternative therapy is a fine thing to do,” said Dr.

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