Mon 28 August 2017
Inflammation has long been suspected to play an important part in the development of cardiovascular disease and results presented at The ESC in Barcelona 2017 has all but confirmed this phenomenon.
A group of leading cardiologists published the results of a randomised study (CANTOS TRIAL) which looked at the effects of an anti-inflammatory drug, Canakinumab, on the combined incidence of repeat heart attack, stroke or death in 10,000 patients who had already suffered from a previous heart attack.
Compared to the control group (who received a placebo drug), the administration of Canakinumab 150mg reduced the incidence of the combined endpoint by 15%. Lower doses of the drug did not show significant benefit.
Dr Paul Ridker of Brigham and Women's Hospital in Boston, said the study ‘represents a milestone in a long journey’, adding that the findings ‘usher in a new era of therapeutics’. He said: "For the first time, we've been able to definitively show that lowering inflammation independent of cholesterol reduces cardiovascular risk. This has far-reaching implications. “It tells us that by leveraging an entirely new way to treat patients - targeting inflammation - we may be able to significantly improve outcomes for certain very high-risk populations."
Of note, there was no improvement in all cause mortality between control and treatment groups. On the contrary,the risk of fatal infection was higher in those treated with Canakinumab compared to control groups. Add to this the extremely high costs of treatment (£40,000 per year per patient compared to £20 with cholesterol lowering medications) and it becomes clear that further work is required before this “magic medicine” proves its worth in the routine medical treatment of cardiovascular disease.