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Imaging as a surrogate marker of drug efficacy in cardiovascular disease.

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cam.issuedOnline2018-10-31
dc.contributor.authorTarkin, Jason M
dc.contributor.authorDweck, Marc R
dc.contributor.authorRudd, James HF
dc.contributor.orcidRudd, James HF [0000-0003-2243-3117]
dc.date.accessioned2018-12-04T00:31:44Z
dc.date.available2018-12-04T00:31:44Z
dc.date.issued2019-04
dc.description.abstractMany cardiovascular drugs in the pipeline will fail to demonstrate a clear clinical benefit when evaluated in large-scale clinical outcome trials; which are costly, require lengthy follow-up, and can potentially expose patients to unforeseen risks. There exists an enormous gap between early mechanistic studies demonstrating proof-of-principle drug efficacy in preclinical models, and successful translation of these therapies into everyday clinical practice. To help overcome this challenge, cardiovascular imaging techniques can be applied to quantify early changes in disease severity owing to drug intervention, or lack thereof, with the aim of informing subsequent clinical outcome trials. This approach can be used to direct valuable resources towards development of drugs most likely to provide real clinical impact. The rationale here is that “surrogate” imaging outcomes can be powered using far less subjects than clinical outcomes in drug trials, as each participant will contribute an imaging endpoint regardless of whether they then go on to develop a clinical event. In addition, drug efficacy can be more rapidly tested using imaging markers as there is no need to wait long periods of time for clinical outcomes to occur. Imaging endpoints in clinical trials might also be used in the future to identify specific sub-groups of patients who are more likely than others to respond to targeted pharmacotherapies in cardiovascular disease—so-called “precision medicine.” This article will discuss the potential scope of imaging to improve drug efficacy testing of current and emerging disease-modifying therapies in atherosclerosis.
dc.format.mediumPrint-Electronic
dc.identifier.doi10.17863/CAM.33596
dc.identifier.eissn1468-201X
dc.identifier.issn1355-6037
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/286284
dc.languageeng
dc.language.isoeng
dc.publisherBMJ
dc.publisher.urlhttp://dx.doi.org/10.1136/heartjnl-2017-311213
dc.rightsAttribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/
dc.subjectcardiac imaging and diagnostics
dc.subjectcoronary artery disease
dc.subjectpositron emission tomographic (pet) imaging
dc.subjectBiomarkers
dc.subjectCardiac Imaging Techniques
dc.subjectCardiovascular Agents
dc.subjectCardiovascular Diseases
dc.subjectHumans
dc.subjectMolecular Imaging
dc.subjectReproducibility of Results
dc.subjectTreatment Outcome
dc.titleImaging as a surrogate marker of drug efficacy in cardiovascular disease.
dc.typeArticle
dcterms.dateAccepted2018-10-01
prism.endingPage578
prism.issueIdentifier7
prism.publicationDate2019
prism.publicationNameHeart
prism.startingPage567
prism.volume105
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idBritish Heart Foundation (None)
pubs.funder-project-idWellcome Trust (104492/Z/14/Z)
pubs.funder-project-idEngineering and Physical Sciences Research Council (EP/N014588/1)
pubs.funder-project-idWellcome Trust (211100/Z/18/Z)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (146281)
pubs.funder-project-idCambridge University Hospitals NHS Foundation Trust (CUH) (unknown)
rioxxterms.licenseref.startdate2019-04
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review
rioxxterms.versionVoR
rioxxterms.versionofrecord10.1136/heartjnl-2017-311213

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