Cardiovascular specialists at BWH are leading a new multi-center trial investigating whether the anti-inflammatory drug, low-dose methotrexate, can reduce risk of recurrent myocardial infarction, stroke and cardiovascular death in patients who have had a prior heart attack. Trial participants must also have either diabetes or metabolic syndrome, two conditions associated with an overactive inflammatory response which increases the risk for recurrent cardiovascular events.
“While inflammation is as important as cholesterol in causing heart disease, it remains unknown whether anti-inflammatory treatments can improve outcomes for those who have already suffered a first heart attack,” said Paul M. Ridker, MD, director of the BWH Center for Cardiovascular Disease Prevention. “We are working to address this crucial clinical question.”
Funded by the National Heart Lung and Blood Institute, the Cardiovascular Inflammation Reduction Trial (CIRT) is being led nationwide by Ridker, a cardiologist and pioneer in the field of inflammation biology and heart disease. He is collaborating with a team of BWH investigators including Brendan Everett, MD, MPH; Aruna Pradhan, MD; Daniel Solomon, MD; Nina Paynter, PhD; and Robert Glynn, PhD. Samuel Z. Goldhaber, MD, director of the BWH Thrombosis Research Group, is actively enrolling patients into the trial at BWH, along with Gregory Piazza, MD. Other BWH investigators helping to run the trial include Elaine Zaharris, Jean MacFadyen, Erin Cunniff and Ruth Morrison, RN.
“CIRT represents a unique opportunity to directly test the inflammation hypothesis, using an inexpensive drug already known to be safe and effective for the treatment for rheumatoid arthritis,” said Goldhaber. “The question is whether this same simple therapy can prevent recurrent heart attacks, stroke and death in our high-risk patients.”
Over the five-year study period, CIRT participants will be randomly allocated to usual care plus placebo or usual care plus low-dose methotrexate at a target dose of 15 to 20 milligrams once weekly, a dose range considered safe and widely used for treatment of rheumatoid arthritis. The primary trial endpoint is the rate of recurrent myocardial infarction, stroke or cardiovascular death.
Article provided by BWH Department of Marketing and Planning.