ACC24 Highlights: Triumphs and Setbacks in Cardiology

At the recent American College of Cardiology’s 73rd Annual Scientific Session & Expo (ACC24) in Atlanta, several groundbreaking developments in cardiovascular care were presented. Here's a summary of the key findings:

Novo Nordisk's Wegovy: The drug, recently approved for cardiovascular use, demonstrated positive outcomes in the Phase III STEP-HFpEF study. After one year, patients on Wegovy experienced a significant reduction in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), indicating improved heart function and quality of life. The drug also led to greater weight loss, enhanced six-minute walk distance, and lower C-reactive protein levels compared to the placebo group. These results suggest Wegovy could be beneficial for patients with obesity, heart failure with preserved ejection fraction (HFpEF), and type 2 diabetes. The findings were published in The New England Journal of Medicine, and Novo has submitted the data to the FDA to expand Wegovy's indications to include HFpEF.
Ionis Pharmaceuticals' Olezarsen: This investigational therapy showed significant promise in treating familial chylomicronemia syndrome (FCS). In the Phase III BALANCE study, patients given olezarsen had a 44% reduction in triglyceride levels at six months, which improved to a 59% reduction at 12 months. The treatment also significantly reduced the incidence of acute pancreatitis events. Ionis is preparing to file for regulatory approval, aiming to establish olezarsen as the standard of care for FCS.
Boehringer Ingelheim and Eli Lilly's Jardiance: The SGLT2 inhibitor did not meet its primary endpoint in the Phase III EMPACT-MI trial, which focused on patients post-acute myocardial infarction (MI). The drug did not significantly reduce the risk of heart failure hospitalization or death from any cause. However, it did show a significant 23% reduction in the risk of first hospitalization for heart failure. The study's lead author noted the clinical significance of this reduction in heart failure hospitalizations.
Arrowhead Pharmaceuticals' Plozasiran: This RNAi therapy showed substantial reductions in triglyceride levels in patients at risk of acute pancreatitis, as evidenced by the Phase IIb SHASTA-2 trial. Plozasiran led to a 74% reduction in triglyceride levels at 24 weeks and a 58% average drop at 48 weeks, with a 48% decrease in ApoC3 levels. The company is considering initiating pivotal studies for the treatment of severe hypertriglyceridemia.

These advancements reflect the ongoing innovation and research in cardiovascular care, aiming to improve patient outcomes and expand treatment options for various heart conditions.