polypill (Polycap)

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Introduction

Different versions of a polypill show benefit in various clinical trials

Indications

Computer modelling suggests Polypill would

Adverse effects

Clinical trials

ClinicalTrials.gov number, NCT02278471.[5]

revival of the polypill in an industry-sponspored study[4]

The Indian Polycap Study

South Asian & Southeast Asian countries (NCT01646437)[7]

TIPS-3 trial[10]

Meta-analysis of randomized controlled trials[8]

FOCUS (Fixed-dose Combination Drug for Secondary Cardiovascular Prevention) Project

NCT02596126 Secondary Prevention of Cardiovascular Disease[9]

More general terms

Components

References

  1. 1.0 1.1 Journal Watch 23(16):127, 2003 Wald NJ & Law MR, A strategy to reduce cardiovascular disease by more than 80%. BMJ 326:1419 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12829553 <Internet> http://bmj.com/cgi/content/full/326/7404/1419
    Law MR et al Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326:1423 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12829554 <Internet> http://bmj.com/cgi/content/full/326/7404/1423 Law MR et al Value of low dose combination treatment with blood pressure lowering drugs: analysis of 354 randomised trials. BMJ 326:1427 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12829555 <Internet> http://bmj.com/cgi/content/full/326/7404/1427
    Rodgers A et al A cure for cardiovascular disease? Combination treatment has enormous potential, especially in developing countries. BMJ 326:1407 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/12829526 <Internet> http://bmj.com/cgi/content/full/326/7404/1407
  2. Thom S et al Effects of a Fixed-Dose Combination Strategy on Adherence and Risk Factors in Patients With or at High Risk of CVD. The UMPIRE Randomized Clinical Trial. JAMA. 2013;310(9):918-929. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24002278 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1734704
    Gaziano JM Progress With the Polypill? JAMA. 2013;310(9):910-911 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24002274 <Internet> http://jama.jamanetwork.com/article.aspx?articleid=1734680
  3. 3.0 3.1 Castellano JM et al. A polypill strategy to improve adherence: Results from FOCUS (Fixed-dose Combination Drug for Secondary Cardiovascular Prevention) Project. J Am Coll Cardiol 2014 Sep 1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25193393
  4. 4.0 4.1 4.2 Roshandel G, Khoshnia M, Poustchi H et al Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial Lancet. vol 394, ISSUE 10199, P672-683, August 24, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31448738 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31791-X/fulltext
  5. 5.0 5.1 5.2 Munoz D, Uzoije ), Reynolds C et al Polypill for Cardiovascular Disease Prevention in an Underserved Population. N Engl J Med 2019; 381:1114-1123. Sept 19, 2019 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31532959 https://www.nejm.org/doi/full/10.1056/NEJMoa1815359
  6. Joyner MJ, Paneth N. Cardiovascular Disease Prevention at a Crossroads:Precision Medicine or Polypill? JAMA. Published online November 25, 2019. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31764938 https://jamanetwork.com/journals/jama/fullarticle/2756239
  7. 7.0 7.1 Yusuf S et al. Polypill with or without aspirin in persons without cardiovascular disease. N Engl J Med 2020 Nov 13; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/33186492 https://www.nejm.org/doi/10.1056/NEJMoa2028220
  8. 8.0 8.1 8.2 Joseph P, Roshandel G, Gao P et al. Fixed-dose combination therapies with and without aspirin for primary prevention of cardiovascular disease: An individual participant data meta-analysis. Lancet 2021 Aug 27; PMID: https://www.ncbi.nlm.nih.gov/pubmed/34469765 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01827-4/fulltext
  9. 9.0 9.1 9.2 Castellano JM et al. Polypill strategy in secondary cardiovascular prevention. N Engl J Med 2022 Aug 26; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36018037 https://www.nejm.org/doi/10.1056/NEJMoa2208275
    Wang TJ. The polypill at 20 - What have we learned? N Engl J Med 2022 Aug 26; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/36018010 https://www.nejm.org/doi/10.1056/NEJMe2210020
  10. 10.0 10.1 Bosch JJ, O'Donnell MJ, Gao P et al Effects of a Polypill, Aspirin, and the Combination of Both on Cognitive and Functional Outcomes. A Randomized Clinical Trial. JAMA Neurol. Published online January 30, 2023. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36716007 https://jamanetwork.com/journals/jamaneurology/article-abstract/2800416