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CANTOS: Anti-Inflammatory Drug Cuts CV Events, Cancer

The anti-inflammatory drug canakinumab (Ilaris, Novartis) significantly decreased the risk of recurrent major CV events without any effect on cholesterol and, in a surprising twist, also dramatically cut rates of new lung cancer and lung-cancer mortality, according to results of the eagerly anticipated CANTOS trial.

The study, in more than 10,000 high-risk patients who had a prior MI and persistently elevated high-sensitivity C-reactive protein (hs-CRP) levels, showed that patients who received subcutaneous canakinumab 150 mg every 3 months had a 15% reduced risk for the composite primary end point of nonfatal MI, nonfatal stroke, and CV death compared with those receiving placebo (P=0.02075).

For the secondary composite end point that also included unstable-angina hospitalization leading to urgent revascularization, the risk was reduced 17% (P=0.00525).

A 300-mg dose of canakinumab produced similar reductions but failed to meet the prespecified threshold after adjustment for multiplicity for statistical significance, while a 50-mg dose had no effect.

The benefit of treatment was consistent across all patient groups. Treatment with the monoclonal antibody also reduced the need for revascularization by about 30% (P<0.0001).

 

  1. Ridker PM, Everett BM, Thuren T, et al. Anti-inflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017; DOI:10.1056/NEJMoa1707914. Article
  2. Ridker PM, Danielson E, Fonseca FAH, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359:2195-2207.
  3. Ridker PM, MacFadyen JG, Thuren T, et al. Effect of interleukin-1β inhibition with canakinumab on incident lung cancer in patients with atherosclerosis: Exploratory results from a randomized, double-blind, placebo-controlled trial. Lancet. 2017; DOI:10.1016/S0140-6736. Article