Anti-inflammatory therapy with canakinumab—targeting the interleukin-1β (IL-1β) innate immunity pathway—reduces cardiovascular events in patients with previous myocardial infarction (MI), reports a trial in The New England Journal of Medicine.
The industry-sponsored “Canakinumab Antiinflammatory Thrombosis Outcome Study” (CANTOS) enrolled 10,061 adults with a history of MI. All had a persistent proinflammatory response, with high-sensitivity C-reactive protein of 2 mg/L or higher. Patients were randomly assigned to receive canakinumab every 3 months, 50, 150, or 300 mg sc; or placebo. Rates of nonfatal MI or stroke or cardiovascular death were compared between groups.
All three canakinumab doses reduced high-sensitivity C-reactive