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Independents' Day

Anti-inflammatory injection significantly reduces heart attack risk, finds study

Anti-inflammatory injections may significantly reduce the risk of secondary cardiovascular disease without the need for statins, a study has found.

Patients who had injections of an anti-inflammatory monoclonal antibody were less likely to suffer a new cardiovascular event.

The study, led by a team from Brigham and Women’s Hospital in Boston and funded by Novartis, allocated just over 10,000 patients with a previous history of heart attack to receive either the anti-inflammatory injection (canakinumab) or a placebo.

Patients who received the second highest dose of canakinumab had a 15% reduction in risk of subsequent cardiovascular events after 48 months of follow up compared to those who took a placebo.

Lipid levels in patients receiving canakinumab did not reduce significantly from baseline, suggesting that the benefits of the drug in reducing cardiovascular disease risk occur independently of lipid-lowering action.

Cancer mortality in patients who received canakinumab was also significantly lower than in patients who had the placebo.

There were, however, significantly more deaths from infection or sepsis in the canakinumab group compared to the placebo, and no significant difference between the groups in deaths from any cause.

Canakinumab works by targeting an interleukin involved in the inflammatory pathway, which has been associated with increased risk of cardiovascular events in previous research.

Dr Chris Arden, GPSI in cardiology in Southampton, said: ’This research poses more questions than answers at this stage but it opens up the idea of using inflammatory markers as a potential way of risk-stratifying patients.

‘We all recognise that inflammation is important in atherosclerotic disease and this suggests that treating it is of potential benefit, but we’ll need a lot more evidence before this can be embedded in to clinical practice.

‘The potential is exciting but I think we’re at the start of a journey – statins will be around for a while to come.’

N Engl J Med 2017; available online August 27th

Readers' comments (2)

  • £10k an ampule 3 x a year can this be afforded.I doubt it.

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  • Vinci Ho

    Interesting from this article, as quoted,
    ''....... beneficial outcomes after statin therapy relate to both a reduction in cholesterol level and inflammation inhibition.Yet, to date, no evidence has shown that reducing vascular inflammation in the absence of concomitant lipid lowering reduces the rates of cardiovascular events. As such, the inflammatory hypothesis of atherothrombosis has remained unproved.''

    For this particular monoclonal antibody (-mab) drug,Canakinumab,to be effective in reducing further cardiovascular events after initial MIs in this report , cholesterol levels were not much affected . So , does this mean the inflammatory and lipid-related components associated with MIs are , in essence , independent.
    This may reinforce my belief that as long as you are on statin at some dosage , protection still occurs even though the set targets for various cholesterols( more about non-HDL cholesterol these days) are not reached .

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