Quadruple therapy should be 'new therapeutic standard'
for heart failure, say researchers
This is the MIMS headline, heralding a Lancet study that "found significant gains in life expectancy associated with a 'comprehensive contemporary regimen' comprising an angiotensin II receptor antagonist/neprilysin inhibitor (ARNI), beta-blocker, aldosterone antagonist and SGLT2 inhibitor, compared with conventional therapy".
So should patients with heart failure feel reassured that pharmaceutical medicine has found a successful treatment for their condition?
The drugs mentioned by MIMS are well known; and each one of the pharmaceutical drug mentioned has well known and serious adverse reactions; that is, they are potentially very harmful to our health. This, of course, is not mentioned by MIMS.
Angiotensin II receptor antagonists/neprilysin inhibitors (ARNI)
This class of drugs includes valsartan and losartan. The known side effects of these drugs include mental confusion, irregular heartbeat, hypotension, chest pain, and much else (click on the individual drug above to see a full list of harmful side effects that conventional medicine already admits).
Beta-blockers
These drugs have been marketed to patients with heart conditions for decades. They include Acebutolol (Sectral), Atenolol (Tenormin), Bisoprolol (Zebeta), Metoprolol (Lopressor, Toprol XL), Nadolol (Corgard), Nebivolol (Bystolic) and Propranolol (Inderal, InnoPran XL). They all have well known side effects which include fatigue, weight gain, depression, shortness of breath, insomnia, and much much more.
Aldosterone antagonists
These include epleronone and spironolactone, both of which have long list of serious side effects, including irregular heartbeat, seizures, shortness of breath, loss of consciousness, and much else.
SGLT2 inhibitors
These include canaglifozin, empagliflozin and dapagliflozin, which all come with very long lists of serious mental and physical side effects too.
In addition to the known side effects caused by each of these four classes of drug, combining them will inevitably lead to drug interactions, which will add to the already long list of potential side effects of this combined treatment.
MIMS, of course, talks up the prospects of this polypharmaceutical madness. They confirm that the researchers "found that over a lifetime of use, assuming consistent treatment effects, the comprehensive regimen could add up to 8 years of survival free from cardiovascular events and hospitalisation due to heart failure."
Yet notice that the comparator used in this research is not a safer, more effective natural therapy, like homeopathy, but "with conventional therapy" - that is, treatments that has failed to treat heart failure over many decades, and which has probably added to the epidemic levels of heart failure that we are now experiencing.
The best predictor of future performance is past performance, and if so, MIMS unbridled optimism flies in the face of all experience of pharmaceutical medicine, especially in the last 70 years. There is no doubt this treatment will now be used with hundreds of thousands of patients with heart failure around the world. - Let's hope that no patient undertakes this treatment without first being warned by doctors about the long list of serious side effects that will inevitably be involved.
- Let's hope no-one agrees to this treatment without checking for themselves the appalling track record of each of these drugs.
- Let's hope the outcome for all these patients fulfills the optimism of MIMS rather than past performance of pharmaceutical medicine.
But I, for one, will not be holding my breath -
This is pharmaceutical drug treatment best avoided at all costs.
