Resuscitating Cardiovascular Drug Development

In the past decade, the rate of improvements in cardiovascular disease outcomes has been impressive. But the reduced number of drugs in development now threatens to reduce the speed of achievement. Although coronary artery disease remains the leading cause of death and disability globally, drug development for cardiovascular disease (CVD) has declined dramatically over the past 20 years.¹ The percentage of phase 3 studies for medications specific to cardiovascular indications declined 3-fold between 1990 and 2012 (Figure),² and there have been no US Food and Drug Administration Cardiovascular and Renal Drugs advisory committee meetings since 2015.³ A thin development pipeline is of even more concern: the percentage of phase 1 studies for CVD has declined just as significantly (Figure).²