Key result
Reducing inflammation through IL-1β inhibition with canakinumab significantly reduced vascular risk, including a 31% reduction in cardiovascular and all-cause mortality among optimal responders.
Why the study?
Life-threatening cardiovascular events occur despite control of conventional risk factors, and inflammation measured by hsCRP is associated with future vascular events independent of usual risk markers.
Does anti-inflammatory therapy targeting the IL-1β pathway reduce atherothrombotic risk in patients with residual inflammatory risk?
Does anti-inflammatory therapy targeting the IL-1β pathway reduce atherothrombotic risk in patients with residual inflammatory risk?
Targeting the IL-1β inflammatory pathway with agents like canakinumab provides additional atheroprotection beyond standard lipid-lowering therapy in patients with residual inflammatory risk.
Life-threatening cardiovascular events occur despite control of conventional risk factors. Inflammation, as measured by high-sensitivity C-reactive protein (hsCRP) concentration, is associated with future vascular events in both primary and secondary prevention, independent of usual risk markers. Statins are powerful lipid-lowering agents with clinically relevant anti-inflammatory effects. Recent data support targeting the interleukin (IL)-1-to-IL-6-to-CRP signaling pathway as an adjunctive method for atheroprotection. The CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study) trial showed that reducing inflammation through IL-1β inhibition significantly reduced vascular risk, beyond that achievable with lipid lowering. CANTOS further demonstrated a 31% reduction in cardiovascular mortality and all-cause mortality among patients treated with canakinumab who achieved the largest reductions in hsCRP, as well as efficacy in high-risk patients with chronic kidney disease and diabetes. This review outlines the clinical implications of CANTOS for patients with "residual inflammatory risk," the potential benefits and risks associated with anti-inflammatory therapy, and the importance of CANTOS for future drug development.
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Paul M. Ridker (2018) conducted a review in Atherothrombotic risk. Canakinumab (IL-1β inhibition) was evaluated on Cardiovascular mortality and all-cause mortality (31% reduction). Reducing inflammation through IL-1β inhibition with canakinumab significantly reduced vascular risk, including a 31% reduction in cardiovascular and all-cause mortality among optimal responders.
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