Harnessing The Potential Of A Single Polypill

The ‘polypill’ was first tabled as a global heart care solution at a World Health Organization (WHO) and Wellcome Trust meeting of medical minds in 2001. Its potential benefits have been heralded as the answer to ensuring patients adhere to treatment.

It could also seriously reduce the cost of drugs, making a huge impact on the 80% of people suffering with cardiovascular diseases who live in low and middle-income countries. It is this potential that The George Institute for Global Health, along with various collaborators, is investigating as part of its cardiovascular research program.

The polypill trials underway at The George are underpinned by the significant opportunity to address cardiovascular disease on a global scale. Three separate studies, involving people from across the world, are investigating whether the polypill can provide improvements in long-term treatment rates. Researchers are also testing this new therapy in low, middle and high-income countries, Indigenous populations and those at different levels of risk.

The polypill contains four different components - a cholesterol lowering medication, two blood pressure lowering medications and aspirin. In development since 2003, it is now being tested for its benefits for those at risk of heart attack or stroke.

“We set out to drive the solution suggested at the 2001 WHO and Wellcome Trust meeting and hope soon to publish the first of a series of results from three different studies of the polypill. Initially, we have assessed the short-term efficacy and side effects among people at raised overall cardiovascular risk”, says leading George Institute researcher Professor Anthony Rodgers.

As more international results come to light, George Institute researchers have high hopes for the role of the polypill.

“While by no means it is seen as a panacea for the prevention of cardiovascular disease, for most disadvantaged communities the prospect of a polypill holds considerable promise for helping people at greatest risk”, added George Institute Associate Professor Anushka Patel.

A key research question is whether the polypill will also close treatment gaps. Previous research has shown many individuals with vascular disease do not continue medications in the long term, due perhaps to the complexities and cost of taking multiple drugs. This problem is particularly pronounced in developing countries.

The George Institute in India, with the Centre for Chronic Disease Control, the Public Health Foundation of India, and other collaborators, will oversee one of the polypill projects in India. The impact of such an affordable treatment in India could benefit many people and address gaps in treatment. In India, 80% of health care is paid out of pocket with the majority of people not able to access cardiovascular drugs.

“In an area of the world where rates of cardiovascular disease are rapidly increasing, reliable evidence about the effectiveness of new strategies to provide cost-effective preventative therapies to those at greatest risk are urgently required. We believe this trial will provide such evidence for a ‘polypill-based’ strategy”, said George Institute Associate Professor Anushka Patel.

Two other parallel polypill projects are already underway in Australia and New Zealand. Collectively, these parallel trials will include around 7,000 participants in ten countries and will evaluate the potential of the polypill treatment strategy in preventing cardiovascular events.