Monday, July 19, 2010


I spend part of Saturday and Sunday attending the Asia Pacific CV summit at the Hilton KL, at the invitation of Astra Zeneca. I was quite amazed that a pharma meeting could have such a grand title. It looks like AZ is trying very hard to re-invent Rosuvastatin, their number 1 product. They did bring down here quite an array of overseas faculty. No really big names. There was also a satellite symposium session from the American College of Cardiology featuring Dr Paul Ridker and Dr Antonio deMaria, speaking from the USA.
AZ does have quite a few good CV drugs which can help our patients. Of course the most popular and best selling, I think is Rosuvastatin ( Crestor ) for LDL-C lowering, anti-inflammatory and as we heard at the weekend, also a fairly effective HDL-C raiser. The data presented seemed to suggest that Crestor >20mg daily is safe. That is not quite my understanding. It is nice to know that if you care to use crestor >20mg, you may get to raise your HDL-C by 15%. Then again, there seemed to be some difference in protection between endogenous HDL-C and drug stimulated HDL-C. We learned this hard lesson from the " Torcetoprib fiasco ', the hard way.
Certainly, the data on rosuvastatin lowering hs-CRP is very firm. I must say that lowering hs-CRP is protective, except that I do have some difficulty finding a reliable hs-CRP laboratory. They seem so variable, depending on when and which lab measures them. In fact, looking at world-wide literature, accurate hs-CRP measurement seemed to be a " Paul Ridker Boston phenomena ". Many of us cannot get the same consistency and reliability.
I was very surprise at the lack of discussion on Candesartan, another important AZ product for BP control and CV risk modification. I wonder whether the organisers felt that they should avoid the on-going ARB - cancer controversies. CHARM was only mentioned in passing.
I wen there partly to hear Dr Gilles Montalescot discuss the new anti-platelet agent, ticagrelor, which I thought AZ was trying to launch. There was passing mention made on Ticagrelor, but I thought that Dr Montalescot was very fair, in mentioning more of the current problem with Clorpidogrel and also Prasugrel. In the limited time given to him, he dealt with the topic quite well. A good overall perspective.
Looks like there will be another meeting on Ticagrelor, which looks promising, given the data from PLATO. A reversible ADP receptor blocker can be useful, although it does have some downside. One day we should discuss PLATO here.
All in all, a good effort by AZ, but I fear that it may have cost them a bomb, flying so many speakers and delegates from all over Asia Pacific here.

1 comment:

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