Guest: Dr. Christopher Cannon
Presenter: Neal Howard
Guest Bio: Dr. Christopher Paul Cannon is a cardiovascular medicine specialist at Brigham and Women’s Hospital (BWH) and a professor of medicine at Harvard Medical School (HMS). Dr. Cannon is the executive director of cardiometabolic trials at the Harvard Clinical Research Institute. Dr. Cannon earned his medical degree from Columbia University College of Physicians and Surgeons. He completed an internal medicine residency at New York-Presbyterian Hospital and a cardiology fellowship at BWH. Dr. Cannon is board certified in internal medicine.
Health Professional Radio – JARDIANCE
Neal Howard: Welcome to Health Professional Radio, I’m your host Neal Howard on this Health Supplier Segment of the program. Now there’s some very important news that I’ve got to share about one of the major complications associated with type 2 diabetes. Now a lot of people may not know that cardiovascular disease is the leading cause of death for people with type 2 diabetes, responsible for about 2 out of every 3 deaths in the United States. Now the U.S. FDA recently approved a treatment that can help folks reduce the risk of cardiovascular death in adults with type 2 diabetes and here to talk about this new approval is Dr. Christopher Cannon, cardiovascular division of Brigham and Women’s Hospital and also professor of Medicine at Harvard Medical School. Welcome to Health Professional Radio today Dr. Cannon.
Dr. Christopher Cannon: Well thank you very much for having me.
N: Thank you. Now tell us a bit about yourself, other than what I’ve said. What prompted you to become interested in cardiovascular issues?
C: Well I’m a cardiologist and it’s been for all over 25 years. My father was a cardiologist as well so I suppose I have been interested in preventing heart attacks has been my area of focus. I think we as cardiologists have had growing focus on type 2 diabetes because these are patients who become our patients with cardiovascular disease. And so a growing epidemic that unfortunately has very serious consequences, so the development of cardiovascular disease ends up being really the major complication in diabetes. Unfortunately, there are many complications in diabetes but certainly one that is of key focus for us.
N: What has been the old standard treatment for someone that has cardiovascular issues and type 2 diabetes?
C: Well in treating diabetes, since we have 12 or more classes of drugs that have been approved and are in use for lowering the glucose. And quite surprisingly, study after study has failed to show improvements in the risk of dying or heart attack after stroke when using more intensive lowering of the glucose with the older classes of drugs. And so this is an ongoing problem because as you mentioned of diabetics who died, two out of three of them die from cardiovascular disease and so all of these treatments really have not been sufficient in trying and improving the outcomes for our patients.
N: Talk about this new development.
C: Well, it’s very exciting. I think the FDA has granted an approval for a new indication for use. This is for a drug called ‘Empagliflozin or Jardiance,’ where it’s new indication is to produce the risk of cardiovascular deaths among patients with type 2 diabetes and known cardiovascular disease. So this is the first, there are no other diabetes treatments that have this as an indication from the FDA and part from the research we just mentioned that has failed to show that and so this agent will seem to reduce the risk of cardiovascular death and so a really exciting development that the FDA has now put into the package information.
N: Now in addition to the obvious research findings that supported the approval, did the findings mentioned anything about different types of age or gender issues that may affect the effectiveness of this new drug?
C: Well interestingly, this was something that applied to all of the different subgroups of patients within the study. So the approval was based on a study of about 7,000 or so patients who have type 2 diabetes and known cardiovascular disease. All of them are receiving their standard therapy and then some of them were given empagliflozin on top and so what we’re seeing was a reduction in cardiovascular death and …stroke or heart attack or stroke and then the FDA called particular attention to a 38% reduction in cardiovascular death. And what you just asked, this was seen whether patients are women or men, or by race, or age category in the study and so really amongst those patients with known disease, it really applied across the board.
N: Now are there any avenues where we can go and learn more about this new FDA approval and as we wrap up, could you talk a bit about maybe some unexpected beneficial side effects that often happens when drugs go through research? Some things that we didn’t count on sometimes happen, is there anything like that as far as this brand new approval is concerned?
C: Well the surprises are that there’s actually reduced cardiovascular death because for decades we have not seen it and so this is a wonderful development. It becomes a ‘call-to-action’ for us as doctors to really re-look at how we’re managing our patients with diabetes and cardiovascular disease and say, ‘Is this an appropriate new therapy to add in?’ And to look at all the therapies, take this as a moment to say, ‘Wait, let’s double check if the overall regimen because this fits into the overall treatment where we’d be controlling blood pressure, and cholesterol, and other risk factors.’ And so a really wonderful new era where we’re shifting from worrying about what sugar level is to trying to improve the outcomes for patients – a great new era.
N: And where can our listeners go and learn more?
C: Well, I think there are information in the FDA website, the study was published in the New England Journal of Medicine, the medication, the website there, jardiance.com has the information that led to the approval. But I think the best is really to talk about it with your doctors or the patients, either the primary care doctor or cardiologist to see how does this fit in to their overall treatment program.
N: Well I sure thank you for coming in today doctor.
C: Well, thank you very much for having me.
N: Thank you. You’ve been listening to Health Professional Radio for this Health Supplier Segment. I’m your host Neal Howard, in studio with Dr. Christopher Cannon, cardiovascular division of Brigham and Women’s Hospital and also professor of medicine at Harvard Medical School. Transcripts and audio of this program are available at healthprofessionalradio.com.au and also at hpr.fm, and you can subscribe to this podcast on iTunes.