New Medication Reduces Leukotriene Production Following Acute Coronary Syndrome

Patients who suffer from acute coronary syndrome (ACS) are at an increased risk for another ACS attack. According to new study results from the Montreal Heart Institute, a new medication, 5-Lipoxygenase Inhibitor VIA-2291 (Atreleuton), reduces leukotriene production following ACS. Leukotrienes have been linked to unstable atherosclerotic plaques and cardiovascular events, and the researchers, led by Jean-Claude Tardif, MD, hope that the new medication will reduce the rate of repeat cardiovascular events.

The double-blind study, which was also published in Circulation: Cardiovascular Imaging, included 191 patients who were randomly assigned 25, 50, or 100 mg VIA-2291 or placebo daily for 12 weeks. All patients receiving VIA-2291 achieved a significant reduction in leukotriene production, and “no serious adverse events were considered related to study drug,” according to the Circulation abstract.

A subset of 93 patients who had a 64-slice coronary CT examination at baseline continued taking VIA-2291 for 24 weeks and then underwent a repeat scan. Although five of these patients withdrew from the study or were non-compliant, and 28 had scans that were non-evaluable, the researchers obtained results on the 60 remaining patients. New coronary plaques were seen “in 5 of 18 (27.8%) placebo-treated patients and in 2 of 42 (4.8%) VIA-2291—treated patients (P=0.01).” According to the Circulation abstract, “a reduction in noncalcified plaque volume at 24 weeks versus placebo was observed in VIA-2291—treated groups in the 34 of these 60 patients in whom this end point was analyzable (P<0.01).”

Tardif believes the promising results are the first step toward new treatment options for patients with ACS.

“Up to now, standard treatments for patients with acute coronary syndrome (unstable angina and infarct) have not specifically reduced inflammation, an important component of atherosclerosis,” said Tardif. “However, research in recent years has allowed us to determine that the presence of inflammation significantly increases the risk of recurrence among these patients. The clinical study was conducted with about 200 patients, and the findings we’re publishing show that VIA-2291 may finally offer the solution we need to target and reduce inflammation. In fact, these newly published data strongly support the evaluation of VIA-2291 in larger outcome trials.”