Atherosclerosis as an inflammatory disease: Doubts? No more

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Atherosclerosis and cardiovascular disease. Intervention: Canakinumab (IL-1β monoclonal antibody) vs. Placebo. Primary outcome: Incidence of heart attack, stroke, and death (discussed from CANTOS trial).

Q: What does this research mean for the field?

Canakinumab lowers the incidence of cardiovascular events without reducing LDL cholesterol, confirming the inflammatory hypothesis of atherosclerosis. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Mauro Vaccarezza; Cristina Balla; Paola Rizzo

doi:10.1016/j.ijcha.2018.03.003

March 20, 2018IJC Heart & VasculatureOpen Access

Atherosclerosis as an inflammatory disease: Doubts? No more

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Why the study?

Does targeted anti-inflammatory therapy with canakinumab reduce cardiovascular events in patients with prior myocardial infarction and residual inflammatory risk?

Structured PICO

Does targeted anti-inflammatory therapy with canakinumab reduce cardiovascular events in patients with prior myocardial infarction and residual inflammatory risk?

P

Population

Patients with atherosclerosis and prior myocardial infarction at residual inflammatory risk (discussing the CANTOS trial population of >10,000 heart attack survivors with well-controlled lipid levels).

I

Intervention

Canakinumab (anti-IL-1β monoclonal antibody), 150 mg subcutaneous injection every three months.

C

Comparator

Placebo.

O

Outcome

Incidence of myocardial infarction (heart attack), stroke, and death.composite

Limitations

IL-1 activity is not easily measurable and baseline CRP levels may be a poor predictor of treatment response
High cost of canakinumab (approximately US $67,000 per year of therapy)
Slightly higher risk of infection in the canakinumab-treated population
IL-1 activity is difficult to measure directly and baseline CRP may be a misleading predictor of response
Extremely high cost of therapy (roughly US $67,000 per year)
Slightly higher risk of infection in treated patients

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Implication

This editorial highlights how the CANTOS trial provides definitive clinical proof of the inflammatory hypothesis of atherosclerosis, opening a new therapeutic era targeting inflammatory pathways alongside lipid lowering.

Abstract

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Cite This Study

Vaccarezza et al. (2018) conducted an editorial in Atherosclerosis and cardiovascular disease. Canakinumab (IL-1β monoclonal antibody) vs. Placebo was evaluated on Incidence of heart attack, stroke, and death (discussed from CANTOS trial).

synapsesocial.com/papers/6ac6e358158260d1570a9fe2 https://doi.org/10.1016/j.ijcha.2018.03.003

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Atherosclerosis as an inflammatory disease: Doubts? No more

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Atherosclerosis as an inflammatory disease: Doubts? No more

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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