O'Donnell, Chris (2025) Pharmacotherapy of cardiovascular diseases from herbs and pills to nucleic acids A report from the European Society of Cardiology Cardiovascular Roundtable. European heart journal. ISSN 1522-9645; 0195-668X

Abstract

Cardiovascular (CV) diseases continue to cause substantial morbidity and mortality. Risk factors are inadequately controlled, compliance with medi�cation remains suboptimal, and treatments are not sufficient to fully prevent the progression of atherosclerotic CV disease, heart failure, arrhyth�mias, and valvular heart diseases. An increased understanding of the genetic basis of CV diseases and advances in the technology of therapeutics have led to the development of nucleic acid–based therapies (NATs) for prevention and treatment of CV risk factors and diseases. Nucleic acid–based therapies can target disease pathways at the translational level preventing the formation of disease-causing proteins that could not be effectively targeted by other pharmacological therapeutics and will likely improve treatment adherence by providing long-acting effects over many months rather than daily treatment. These therapies include RNA-targeted therapeutics, gene editing therapeutics, and gene therapies. Challenges around
the use of NATs may be unique with each new drug and new target and may include long-term unanticipated side effects, and issues around spe�cificity, targeting, and stability. Assessing NATs for marketing approval continues to pose challenges for regulatory agencies. These include their di�verse nature, limited data on pharmacology, clinical safety and efficacy, and the lack of long-term results. Barriers in clinical practice may include the lack of specific education, fear of off target effects, costs, and ethical challenges. Implementation of these novel therapies will require careful patient selection and education. Despite potentially high treatment costs, possible long-term cost savings could result from fewer healthcare visits due to infrequent NAT administrations, and lower rates of disease progression, hospitalization, and CV events due to sustained improvement in control of disease pathways and risk factors.

Item Type:	Article
Keywords:	Nucleic acid therapy, cardiovascular disease, prevention, coronary artery disease, heart failure
Date Deposited:	16 Sep 2025 00:45
Last Modified:	16 Sep 2025 00:45
URI:	https://oak.novartis.com/id/eprint/57722