WHO adds cardiovascular polypill to essential medicines list

The World Health Organization (WHO) has included a cardiovascular polypill—an all-in-one pill containing an antiplatelet, lipid lowering medication, and a blood pressure lowering and vascular stabilising drug (acetylsalicylic acid, ramipril, and atorvastatin)—in its List of Essential Medicines.

Developed by the Spanish National Centre for Cardiovascular Research (CNIC) and the pharmaceutical company Ferrer, the medication has shown to be effective in preventing secondary adverse cardiovascular events in people who have previously had a myocardial infarction (MI), reducing cardiovascular mortality by 33%.

Results of the SECURE trial, presented at the 2022 congress of the European Society of Cardiology (ESC; 26–29 August, Barcelona, Spain) by Valentin Fuster (Centro Nacional de Investigaciones Cardiovasculares [CNIC], Madrid, Spain and Mount Sinai Health System, New York, USA) and published simultaneously in The New England Journal of Medicine, showed that the medication was found to be more effective at reducing the risk of major adverse cardiovascular events than when patients were asked to take the medications separately.

“The SECURE results showed for the first time that the cardiovascular polypill that we helped develop led to clinically relevant reductions in recurrent cardiovascular events in patients who had suffered a myocardial infarction,” said Fuster. “Adherence to treatment after an acute myocardial infarction is essential for effective secondary prevention. This cardiovascular polypill, as a strategy that combines three of the baseline treatments for these patients, has proven its value, because increased adherence means that patients are being treated for longer and, as a result, have a lower risk of cardiovascular events.”

The Essential Medicines List contains medicines that the WHO considers to be the minimum requirements for any healthcare system. It is updated every two years, and is internationally recognised, helping to prioritise effective and affordable medicines. As stated in the WHO report, “Essential medicines are those that satisfy the priority health care needs of a population. They are intended to be available in functioning health systems at all times, in appropriate dosage forms, of assured quality, and at prices individuals and health systems can afford.”

The polypill is marketed under the brand names Trinomia, Sincronium, and Iltria, depending on the country. It is the only polypill designed patients who have experienced a cardiovascular event that is commercially available in 25 countries, and the feasibility of extending its distribution to additional territories, including the USA, is under analysis.

“The 33% reduction in cardiovascular mortality demonstrates the efficacy of treatment with Trinomia compared to standard treatment. The inclusion of this therapeutic solution in the WHO’s List of Essential Medicines confirms our aim to make a positive impact in society and is an important step in our mission to bring significant and differential value to people with cardiovascular disease,” Oscar Pérez, chief marketing, market access, and business development officer at Ferrer, was quoted as saying in a press release.

Fuster adds: “Since our groundbreaking study was published, we have seen an increase in polypill usage across the world and we are looking forward to have this medicine available in the USA and the rest of the countries where it is not available yet.

“This cardiovascular polypill could become an integral part of global strategies to prevent cardiovascular events in patients who have suffered a heart attack and who are currently already being treated with separate mono-components. This approach has the potential to reduce the risk of recurrent disease and cardiovascular death.”