New study using polypill to reduce Heart problems

[Oldvatr]

Just saw this being flashed up on CNN about some new research published In NEJM
https://www.nejm.org/doi/full/10.1056/NEJMoa2028220

Seems more like the witches cauldron. Chuck it all in and see what it does,

I have not read it yet so not able to properly comment. Seems legit, and I have seen prior warning about this research being started. Some of the headline results that are being reported in the press may need to be taken aboard carefully since they seem pretty fantastical,

 

[Oldvatr]

Not sure if this is the same trial but it is also in NEJM journal
https://www.jwatch.org/fw115743/2019/08/23/4-drug-polypill-cuts-cv-risk

Larger sample base similar reported outcome. Different polypill contents though.

Here is a press report giving their interpretation of the results. I have seen some outlets claiming an 80% reduction in heart disease and a 41% reduction in strokes, but I am curious as to how the actual events reported in the abstract get converted to this level. Relative risk reduction is magic
.https://medicaldialogues.in/cardiol...-may-reduce-cvd-events-by-31-nejm-study-71465

 

[KK123]

So before long they will probably want us to take a pill for a heart problem we haven't got and a blood pressure problem that we haven't got and an issue with 'high' cholesterol that we haven't got! I have no issue with any medication that is tailored to the individual AND required but this 'take this pill which must be a strong one to combat all those things whether you need it or not' approach annoys me. x

 

[Oldvatr]

So before long they will probably want us to take a pill for a heart problem we haven't got and a blood pressure problem that we haven't got and an issue with 'high' cholesterol that we haven't got! I have no issue with any medication that is tailored to the individual AND required but this 'take this pill which must be a strong one to combat all those things whether you need it or not' approach annoys me. x

The study abstract does define the selection criteria which include diabetics as desirable participants. Age matters and old diabetics seem to top the selection criteria. No wonder so many died in the 4.5 year follow up period Even with Covid around that rate exceeds my experience so far.

 

[Oldvatr]

=Actually, I find my calculations for the percentages reported for the polyfiller+aspirin group work out at half the figures they give us in the abstract, but I agree exacly with those for the other two legs.. I have had to assume that the cohorts for each were the same size else comparison cross legs will not be valid which is a weakness in the 2+2 factorial study methodology. So I get a relative risk reduction of 16% not the 33% that others see and as reported by the authors. I suspect that the poly plus leg had half the sample size of the others since the reported events are approx half the others legs. on the placebo side.

 

[Oldvatr]

This pill worries me. The doses are all on the high to max dose side, and some of the meds are supposed to be titrated up over the space of several weeks. There are many contraindications for some of these meds, and they should not be given to people unless there is a specific medical reason. One pill fits all is not a viable treatment as a prophylactic against CVD in my opinion, and even though I have already got sufficient medical need for some of these, I am not taking such a strong cocktail even after several CVD events. These drugs should not be handed out like sweets.

Also, the meds are all identified by their commercial trade names rather than their medical class. This is obviously a marketing exercise rather than a scientific study. This means anyone can try it out by buying from the web, without doctors' supervision which is potentially dangerous. There are contraindications against many common supplements and other medications that may interfere. I note that feeling faint was a cause to stop, but becoming breathless was not. Oh dear, No wonder so many died.