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Some of pharmaceutical science’s most memorable discoveries happen pretty much by accident. A medication that scientists envision as a perfect candidate to treat one ailment instead turns out to be much better suited to treat another unrelated disorder or disease. Such was the case with Viagra.
Back in the early 1990s, pharmaceutical scientists at Pfizer’s research facility in Sandwich, England, developed a chemical compound they dubbed sildenafil citrate. They believed that the drug could significantly reduce the pain of angina pectoris and also reduce high blood pressure that had proved resistant to other forms of treatment.
Clinical Trials Launched
To test those theories about sildenafil, clinical trials were launched to see how effectively the drug could achieve those goals, hopefully with no major adverse side effects. Unfortunately, the performance of sildenafil as a new weapon in the battle against those cardiovascular ailments was less than impressive.
However, in checking study participants for side effects, they found that almost all of their male subjects were experiencing improved sexual performance while taking sildenafil. This was true even among men who had previously been diagnosed as impotent.
Research Takes New Direction
This unexpected finding persuaded Pfizer to take its research on sildenafil in a wholly different direction. Researchers now began looking at sildenafil as a new way to treat erectile dysfunction, a condition that afflicts up to 52 percent of all men to some degree, according to the Cleveland Clinic. Further study confirmed that the medication at least temporarily restored normal or near-normal erectile function in men whose erection problems were caused by insufficient blood supply to the penis, the single biggest cause of ED.
Thus, a serendipitous discovery of sildenafil’s unexpected medicinal property led ultimately to the 1998 introduction of Viagra, Pfizer’s little blue pill that truly revolutionized the treatment of ED in this country and around the world.
A Similar Scenario
A similar scenario is playing out with canakinumab, a human monoclonal antibody that is known to target a cytokine protein known as interleukin 1 beta, which is associated with the inflammatory response observed in a wide array of ailments. Scientists participating in the CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) trial unveiled the findings from their study at the Barcelona meeting of the European Society of Cardiology in late August 2017. The study’s results were also published in “The New England Journal of Medicine.”
Providing the bulk of the funding for the CANTOS trial was Novartis, the pharmaceutical company that markets canakinumab under the brand name Ilaris. This prescription drug has been approved by the Food and Drug Administration as an injectable for the treatment of cryopyrin-associated periodic syndromes and a few other rare but serious auto-inflammatory diseases. Ilaris costs $16,000 per injection, four of which were given to study participants during the year-long trial.
No Effect on Risk of Death
The trial confirmed the role of inflammation in atherosclerosis and showed that canakinumab reduces the risk of adverse cardiovascular events, such as heart attack and stroke, by roughly 15 percent. However, it had no apparent effect on the risk of cardiovascular death.
In an article posted at MedPageToday.com, cardiologist Milton Packer, M.D., said that the CANTOS trial findings were a clear victory for the study’s lead author Paul Ridker, M.D., who has long championed the inflammation hypothesis of atherosclerosis. However, wrote Packer, the findings were probably considerably less positive for Novartis, which would need to overcome two formidable challenges to make the drug a commercial success in cardiology.
Challenges Facing Novartis
First, wrote Packer, “It would need to teach thousands of physicians about the value of measuring inflammatory biomarkers in the bloodstream. And it would need to convince payers to pay for a drug that currently costs $16,000 for each injection.”
While canakinumab’s future as a weapon in the fight against cardiovascular disease may be in doubt, the CANTOS trial’s safety profile for the drug revealed a startling and promising side effect of the medication. Canakinumab significantly reduced the risk of fatal cancers. More specifically, researchers found that a 300-milligram dose of canakinumab reduced the occurrence of lung cancer by 67 percent and the risk of death from lung cancer by 77 percent.
A Serendipitous Discovery
Thus, what started out as an exploration of canakinumab’s potential as a drug to reduce the risk of cardiovascular disease ended up finding that it demonstrated far greater potential as an anti-cancer medication.
Like the discovery of sildenafil’s erection-friendly properties, the CANTOS trial serendipitously revealed that canakinumab may find greater success in an area of medicine not directly addressed by the study.
If this article has piqued your interest and you would like to read additional articles about sexual health and function, as well as other topics of interest to health care consumers, check out our blog.
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