TY - JOUR
T1 - Evolution of the polypill concept and ongoing clinical trials
AU - Castellano, Jose M.
AU - Sanz, Gines
AU - Fuster, Valentin
N1 - Funding Information:
The Centro Nacional de Investigaciones Cardiovasculares, CNIC (Spanish National Center for Cardiovascular Research, CNIC), and Ferrer International have developed an FDC for secondary CVD prevention. The CNIC-Ferrer polypill includes aspirin (100 mg), ramipril (2.5, 5, or 10 mg), and simvastatin (40 mg) and has been extensively tested in preclinical and clinical studies. ). The CNIC-Ferrer polypill (Trinomia) is now registered in Central America at a price 50% less than the price of the 3 generic drugs purchased separately. These 2 studies, funded by the 7th Framework Programme of the European Commission, will clarify the role of the polypill substitution strategy in secondary prevention in a variety of economic and social settings. 29 The F ixed D o se C ombination Dr u g for S econdary Cardiovascular Prevention (FOCUS) project has been designed to go beyond these registry studies, because it will evaluate the effect of the polypill on patient adherence to treatment. FOCUS consists of 2 separate, prospective phases. Phase 1 is a comprehensive analysis in 5 countries of factors that impede appropriate use of CVD interventions. Phase 2 is a randomized, controlled clinical trial testing the CNIC-Ferrer polypill ( Fig. 3
PY - 2014/5
Y1 - 2014/5
N2 - Ischemic heart disease and stroke are the leading causes of death worldwide. What was once thought to be an endemic disease of high income countries has become a global epidemic, as low and middle income countries have adopted Western lifestyles, to the point that noncommunicable diseases are now the main cause of death in these regions, above and beyond communicable diseases, malnutrition, and injury. As a result, a large proportion of individuals at high 10-year risk of a cardiovascular event live in low- and middle-income countries, and the most of all cardiovascular events occur in developing countries. A large amount of evidence supports the use of pharmacological treatment for the prevention of cardiovascular death in this population, including antiplatelet drugs, β-blockers, lipid-lowering agents, and angiotensin-converting enzyme inhibitors, however, the efficacy of cardiovascular event prevention is hampered by several problems, including inadequate prescription of medication, poor adherence to treatment, limited availability of medications, and unaffordable cost of treatment. Here we examine the use of fixed-dose combination therapy, and how this therapy could improve adherence to treatment, reduce the cost, and improve treatment affordability in low-income countries.
AB - Ischemic heart disease and stroke are the leading causes of death worldwide. What was once thought to be an endemic disease of high income countries has become a global epidemic, as low and middle income countries have adopted Western lifestyles, to the point that noncommunicable diseases are now the main cause of death in these regions, above and beyond communicable diseases, malnutrition, and injury. As a result, a large proportion of individuals at high 10-year risk of a cardiovascular event live in low- and middle-income countries, and the most of all cardiovascular events occur in developing countries. A large amount of evidence supports the use of pharmacological treatment for the prevention of cardiovascular death in this population, including antiplatelet drugs, β-blockers, lipid-lowering agents, and angiotensin-converting enzyme inhibitors, however, the efficacy of cardiovascular event prevention is hampered by several problems, including inadequate prescription of medication, poor adherence to treatment, limited availability of medications, and unaffordable cost of treatment. Here we examine the use of fixed-dose combination therapy, and how this therapy could improve adherence to treatment, reduce the cost, and improve treatment affordability in low-income countries.
UR - http://www.scopus.com/inward/record.url?scp=84899643894&partnerID=8YFLogxK
U2 - 10.1016/j.cjca.2014.02.016
DO - 10.1016/j.cjca.2014.02.016
M3 - Review article
C2 - 24786442
AN - SCOPUS:84899643894
SN - 0828-282X
VL - 30
SP - 520
EP - 526
JO - Canadian Journal of Cardiology
JF - Canadian Journal of Cardiology
IS - 5
ER -