Canakinumab reduces risk of cardiovascular events in populations with unmet clinical need

March 12, 2018, Brigham and Women's Hospital

Two new analyses of data from more than 10,000 heart attack survivors worldwide were presented by investigators from Brigham and Women's Hospital at the 2018 American College of Cardiology meeting. Paul Ridker, MD, director of the Center for Cardiovascular Disease Prevention at BWH, and Brendan Everett, MD, director of the General Cardiology Inpatient Service at BWH, assessed whether the anti-inflammatory therapy canakinumab reduced rates of major adverse cardiovascular events and co-morbidities among high-risk atherosclerotic patients with chronic kidney disease (CKD) or those with pre-diabetes/diagnosed type 2 diabetes, respectively. They found that canakinumab substantially reduced cardiovascular event rates in both populations, while having neither clinically meaningful benefits nor substantive harms with respect to adverse renal events or glucose control. Findings related to patients with or at high risk of diabetes were simultaneously published in the Journal of the American College of Cardiology and a paper on the CKD findings is forthcoming.

"Evidence continues to build that inflammation underlies many diseases and health conditions," said Everett. "We find that among heart attack survivors with diabetes or pre-diabetes, canakinumab is effective at reducing risk of . Our data also suggest that as cardiovascular and diabetes take root, the inflammatory pathways underlying them may diverge."

Everett and colleagues found that canakinumab was equally effective at reducing rates of cardiovascular events among with and without diabetes enrolled in the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS). The drug reduced HbA1C levels - a key indicator of glucose tolerance - in patients with diabetes or pre-diabetes for the first six to nine months of the trial, but this effect was not sustained.

In a new analysis led by Ridker, investigators found that canakinumab reduced major adverse cardiovascular event rates among high-risk atherosclerosis patients with moderate to severe , with the largest benefits accrued among those who had the most robust anti-inflammatory response. Canakinumab, an IL-1b inhibitor, represents a new class of therapy for atherosclerotic disease that lowers hsCRP and IL-6 with no effect on lipid levels.

"Moving forward, it will be important to extend these data and test the efficacy of canakinumab in patients with end-stage renal failure undergoing dialysis," said Ridker. "In that setting, hsCRP is a powerful predictor of risk while LDL-C is not, and dialysis is one of the only settings where LDL reduction has not been highly effective."

CANTOS was proposed and designed by investigators in the Center for Cardiovascular Disease Prevention at BWH, in collaboration with Novartis Pharmaceuticals. Ridker received financial support for clinical research from Novartis Pharmaceuticals to conduct the CANTOS. Ridker has served as a consultant to Novartis Pharmaceuticals and is listed as a co-inventor on patents held by BWH that relate to the use of inflammatory biomarkers in cardiovascular disease and that have been licensed to AstraZeneca and Siemens. Other BWH investigators involved in the new CANTOS analyses include Robert Glynn, PhD, Peter Libby, MD, Aruna Pradhan, MD, MPH, and Jean MacFadyen.

Explore further: Response after single treatment with canakinumab predicts which patients will benefit most

More information: Everett, B et al. "Anti-Inflammatory Therapy with Canakinumab for the Prevention and Management of Diabetes" Journal of the American College of Cardiology, 2018.

Related Stories

Response after single treatment with canakinumab predicts which patients will benefit most

November 13, 2017
A new analysis seeks to answer the question of which patients are likely to gain the greatest cardiovascular benefit when treated with the anti-inflammatory agent canakinumab. At the 2017 American Heart Association Scientific ...

Anti-inflammatory therapy cuts risk of lung cancer

August 28, 2017
In most clinical trials for cancer therapy, investigators test treatments in patients with advanced disease. But a recent cardiovascular secondary prevention study has given researchers a unique opportunity: to explore the ...

Inflammation reduction could cut risk of heart attack, stroke

August 28, 2017
A significant reduction in risk of recurrent heart attacks, strokes, and cardiovascular death was found among people who received a targeted anti-inflammatory drug that lowered inflammation but had no effects on cholesterol, ...

Study finds prediabetes patients at heightened risk for cardiovascular and chronic kidney diseases

March 1, 2018
Researchers at the Emory Rollins School of Public Health and U.S. Centers for Disease Control and Prevention have found that high proportions of patients with prediabetes are at substantial risk for cardiovascular disease ...

Intensive BP goals reduce risk of cardiovascular events

December 19, 2017
(HealthDay)—Intensive blood pressure lowering may similarly decrease cardiovascular events in both patients with and patients without type 2 diabetes mellitus, according to a study published online Dec. 6 in Diabetes Care.

Primary prevention could reduce heart disease among type 2 diabetes patients

August 7, 2017
In a Journal of the American College of Cardiology state of the art review published today, researchers from the division of cardiology and the Center for the Prevention of Cardiovascular Disease at the New York University ...

Recommended for you

Prosthetic valve mismatches common in transcatheter valve replacement, ups risk of death

September 24, 2018
In the largest multi-institutional study to date, led by researchers from Penn Medicine, the team found that among patients who underwent a transcatheter aortic valve replacement (TAVR), a high number experienced severe and ...

Study reveals a promising alternative to corticosteroids in acute renal failure treatment

September 21, 2018
A protein produced by the human body appears to be a promising new drug candidate to treat conditions that lead to acute renal failure. This is shown by a study conducted at São Paulo State University (UNESP) in São José ...

Can a common heart condition cause sudden death?

September 20, 2018
About one person out of 500 has a heart condition known as hypertrophic cardiomyopathy (HCM). This condition causes thickening of the heart muscle and results in defects in the heart's electrical system. Under conditions ...

New drugs could reduce risk of heart disease when added to statins

September 20, 2018
New drugs that lower levels of triglycerides (a type of fat) in blood could further reduce the risk of heart attack when added to statins. These new drugs, which are in various stages of development, could also reduce blood ...

Mediterranean-style diet may lower women's stroke risk

September 20, 2018
Following a Mediterranean-style diet may reduce stroke risk in women over 40 but not in men—according to new research led by the University of East Anglia.

Inflammation critical for preventing heart attacks and strokes, study reveals

September 19, 2018
Inflammation, long considered a dangerous contributor to atherosclerosis, actually plays an important role in preventing heart attacks and strokes, new research from the University of Virginia School of Medicine reveals.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.