AstraZeneca and Takeda's Atacand (candesartan cilexetil) received another boost to its profile yesterday, after new data were published in the American Heart Journal showing its use significantly cuts atrial fibrillation in a broad spectrum of individuals with heart failure; a condition that is associated with a decline in cardiac function and which affects some 10%-30% of the patient population. This is the first study to demonstrate a reduction in AF across a broad spread of heart failure patients using an angiotensin receptor blocker.

When added to background therapy, Atacand reduced the risk of AF by almost 18% (5.5% of patients in the treatment arm had one or more AF episodes versus 6.7% in the placebo group) when the data were evaluated at a median 37 months into follow-up of the CHARM study. Interestingly, reduction rates were similar across a broad spread of patients, with variously severe heart failure, preserved or reduced left ventricular function, and with concomitant therapies including ACE inhibitors, beta-blockers and anti-arrhythmic agents.

Lead investigator Dr Anique Ducharme, Montreal Heart Institute, Montreal, Canada, commented: “These exciting data are the first to show that the ARB Atacand can reduce the incidence of AF in such a wide spectrum of heart failure patients including those receiving standard optimal therapy.”

The data come from a new analysis of the CHARM study, which helped Atacand secure approval for the treatment of heart failure in more than 60 countries, including the USA and the European Union, after showing it significantly reduced death and hospital admissions from heart failure in patients with chronic heart failure and left ventricular dysfunction - the first member of the ARB class of drugs to show an additional benefit when added to conventional therapy.

In the study, patients receiving Atacand and an ACE inhibitor showed a 15% lower risk for cardiovascular death or hospitalisation versus those receiving ACE inhibitors alone. Almost 6,400 patients in the original trial did not have AF at baseline, and were included into this new analysis.

Atacand reeled in $974 million for AstraZeneca for the full-year 2005, up 11% over the previous year, and well on track to become a billion-dollar earner.