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Journal Articles Circulation Year : 2021

A Call to Action for New Global Approaches to Cardiovascular Disease Drug Solutions

1 RNSH - Royal North Shore Hospital
2 The University of Sydney
3 Clinical Committee, National Heart Foundation of Australia
4 Radcliffe Department of Medicine [Oxford]
5 Oxford NIHR Biomedical Research Centre
6 Oxford BHF-CRE - British Heart Foundation Centre of Research Excellence [Oxford, Royaume-Uni]
7 Verily Life Sciences Inc
8 Unicatt - Università cattolica del Sacro Cuore = Catholic University of the Sacred Heart [Roma]
9 La Trobe University [Melbourne]
10 UMASS - University of Massachusetts Medical School [Worcester]
11 University of Glasgow
12 Vanderbilt University School of Medicine [Nashville]
13 NUS - National University of Singapore
14 University of Texas Southwestern Medical Center
15 Massachusetts General Hospital [Boston]
16 CSL Ltd
17 NHCS - National Heart Centre Singapore
18 Duke-National University of Singapore Graduate Medical School
19 Brigham and Women’s Hospital [Boston, MA]
20 Bayer AG, Pharmaceuticals Division
21 Sapporo Medical University
22 MIPS - Monash Institute of Pharmaceutical Sciences [Parkville]
23 Faculty of Biology, Medicine and Health [Manchester, UK]
24 Stanford Cardiovascular Institute
25 University of Shanghai [Shanghai]
26 DCAC - Défaillance Cardiovasculaire Aiguë et Chronique
27 CIC-P - Centre d'investigation clinique plurithématique Pierre Drouin [Nancy]
28 INI-CRCT - Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy]
29 Cardiovascular & Renal Clinical Trialists - CRCT - French-Clinical Research Infrastructure Network - F-CRIN [Paris]
Robert Califf
Grant Drummond
Bronwyn A Kingwell
Frank Misselwitz
Tetsuji Miura
Joseph C Wu

Abstract

While we continue to wrestle with the immense challenge of implementing equitable access to established evidence-based treatments, substantial gaps remain in our pharmacotherapy armament for common forms of cardiovascular disease including coronary and peripheral arterial disease, heart failure, hypertension, and arrhythmia. We need to continue to invest in the development of new approaches for the discovery, rigorous assessment, and implementation of new therapies. Currently, the time and cost to progress from lead compound/product identification to the clinic, and the success rate in getting there reduces the incentive for industry to invest, despite the enormous burden of disease and potential size of market. There are tremendous opportunities with improved phenotyping of patients currently batched together in syndromic “buckets.” Use of advanced imaging and molecular markers may allow stratification of patients in a manner more aligned to biological mechanisms that can, in turn, be targeted by specific approaches developed using high-throughput molecular technologies. Unbiased “omic” approaches enhance the possibility of discovering completely new mechanisms in such groups. Furthermore, advances in drug discovery platforms, and models to study efficacy and toxicity more relevant to the human disease, are valuable. Re-imagining the relationships among discovery, translation, evaluation, and implementation will help reverse the trend away from investment in the cardiovascular space, establishing innovative platforms and approaches across the full spectrum of therapeutic development.
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Dates and versions

hal-03756465 , version 1 (22-08-2022)

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Gemma A Figtree, Keith Broadfoot, Barbara Casadei, Robert Califf, Filippo Crea, et al.. A Call to Action for New Global Approaches to Cardiovascular Disease Drug Solutions. Circulation, 2021, 144 (2), pp.159-169. ⟨10.1161/CIR.0000000000000981⟩. ⟨hal-03756465⟩
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