New Promises and Challenges on Inflammation and Atherosclerosis: Insights From CANTOS and CIRT Trials

Frontiers in Cardiovascular Medicine

article

Raymond D. Palmer¹  Mauro Vaccarezza² 

[1] Helium-3 Biotech;Faculty of Health Sciences, School of Pharmacy and Biomedical Science, Curtin University

关键词: cardiovascular risk;    acute coronary syndrome;    atherosclerosis;    ischemic heart disease;    vascular disease;   

DOI  :  10.3389/fcvm.2019.00090

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Atherosclerosis is still a great burden on human health and scientific achievements of the past 30 years have definitively proven the inflammatory causes of the disease (1, 2) highlighted by the results of the CANTOS trial (3). Canakinumab inhibition of interleukin-1 (IL1)-beta has been demonstrated to provide protection against cardiovascular (CV) risk irrespective of lipid levels in a cohort of patients with high C–reactive protein (CRP) levels despite achieving blood lipid control, as measured by high sensitivity C-Reactive Protein (hsCRP) (3). The final demonstration of atherosclerosis as an inflammatory-driven pathology is driving research toward new anti-inflammatory approaches that could influence the natural history of the disease and change the clinical paradigms of therapy. Considering the costs of canakinumab and exploiting different avenues of anti-inflammatory therapies, a more affordable approach has been proposed by the authors of the CANTOS study (4). Low dose methotrexate (MTX) proposed in the CIRT study (5) could be an alternative approach aimed to lower the inflammatory burden and to deliver a beneficial effect on patient CV risk (4). Data from this study is now available (5) and demonstrates the feasibility of the low MTX treatment and at the same time a somewhat surprising lack of effect on CV risk.

【 授权许可】

CC BY