Biotech Values

[rfj1862]

Infection and PAD

The idea that infection and atherosclerosis may be linked is not new. C. pneumoniae is found in about 50% of atherosclerotic lesions. Given that PAD is an atherosclerotic disease, it *was* reasonable to assume that antibiotics might have a beneficial impact.

The potential for an antibiotic to influence progression of atherosclerosis has been tested clinically. See, for example, the PROVE-IT trial, in which 4162 patients were randomized to pravastatin or atorvastatin, then rerandomized to gatifloxacin or placebo. There was no difference between gatifloxacin and placebo for the composite of all-cause death or MACE, the primary end point.

Also see: http://content.nejm.org/cgi/content/full/352/16/1706.

Based on these data, I find it rather unlikely that rifalazil will succeed in providing a clinically meaningful change in walking distance or any other PAD outcome. Even potent lipid lowering has little effect (see TREADMILL study).