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Emerging treatment options to improve cardiovascular outcomes in patients with acute coronary syndrome: focus on losmapimod

Authors Kragholm K, Newby K, Melloni C

Received 30 April 2015

Accepted for publication 16 June 2015

Published 5 August 2015 Volume 2015:9 Pages 4279—4286

DOI https://doi.org/10.2147/DDDT.S69546

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Wei Duan


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Kristian Kragholm, Laura Kristin Newby, Chiara Melloni

Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA

Abstract: Each year, despite optimal use of recommended acute and secondary prevention therapies, 4%–5% of patients with acute coronary syndrome (ACS) experience relapse of ACS or other cardiovascular events including stroke, heart failure, or sudden cardiac death after the index ACS. The sudden atherosclerotic plaque rupture leading to an ACS event is often accompanied by inflammation, which is thought to be a key pathogenic pathway to these excess cardiovascular events. Losmapimod is a novel, oral p38 mitogen-activated protein kinase (MAPK) inhibitor that targets MAPKs activated in macrophages, myocardium, and endothelial cells that occur as a part of global coronary vascular inflammation following plaque rupture. This review aims to 1) discuss the pathophysiological pathways through which p38 MAPKs may play key roles in initiation and progression of inflammatory disease and how losmapimod is thought to counteract these p38 MAPKs, and 2) to describe the efficacy and safety data for losmapimod obtained from preclinical studies and randomized controlled trials that support the hypothesis that it has promise as a treatment for patients with ACS.

Keywords: p38 MAPK, p38 MAPK inhibitor, losmapimod, safety, efficacy, outcomes

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