17 April 2024

Is there no limit to what can be solved with an injection?

The Back Page

Welcome to the future of medicine.


Imagine a world where you only needed to see each patient twice a year and treating them was as easy as a few injections.  

Give them a flu shot, covid shot etc, and tack on a variety of other injectables to combat all their ailments. Jab each patient a few or a dozen times depending on their needs, then send them off and do it again in six months’ time. 

Recent research suggests that this may be the direction medicine is taking, and this Back Page correspondent is all for it. A few injections to undo the outcomes of my genetic predispositions and self-destructive lifestyle choices? Sign me up! 

The American College of Cardiology reckons a single injection of “investigational drug” zilebesiran could substantially reduce systolic blood pressure with a lasting effect of three months, with some people still experiencing a reduction at six months. 

This study comes at a time when a twice-yearly shot to control cholesterol has just won PBS listing, and people are even signing up to be injected with experimental drugs to reduce lipids in their blood. 

A total of 672 patients with an average blood pressure of 143mmHg who were taking up to two antihypertensive medications were enrolled. The study switched them all randomly to one of three standard once daily medications (indapamide, amlodipine or olmesartan). After four weeks of the new oral treatment and a stable systolic of between 130-160mmHg, they were injected either with a placebo or 600mg of zilebesiran and monitored for six months. 

Pairing the zilebesiran injection with indapamide resulted in the greatest effect, with the average reduction of 12mmHg. For amlodipine, the average reduction was 9.7mmHg and for olmesartan, 4mmHg. 

Compared with placebo, authors described this reduction in systolic blood pressure as clinically meaningful and suggested it could be a potent strategy. Akshay Desai, one of the study authors, cited previous studies which have shown that a 10mmHg reduction in systolic blood pressure results in a 20% reduction in heart attack or stroke risk.  

This could have the potential to reduce cardiovascular burden on the healthcare system, and a twice-a-year injection could greatly promote treatment adherence. 

At this stage, all of these injections are to be used in conjunction with oral treatments and as part of a combined treatment plan. But hey, who knows? Maybe in a few years it will be as simple as a bi-annual check-up with your GP, featuring a variety of injectables. 

Been busy with work and understandably neglecting exercise? Too bloody tired to chop up a million vegetables for a “healthy” dinner every night? Drawn the short end of the stick with the genetic roulette of your conception?  

No worries! Inject the pain away. 

If you have story tips or anything else that should be solvable with a bi-annual jab, send them to penny@medicalrepublic.com.au. 

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