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CANTOS – one year on: What have we learned?

ESC Congress News 2018 - Munich, Germany

At ESC Congress 2017, results from the CANTOS trial provided the first evidence that anti-inflammatory therapy with canakinumab, targeting the interleukin (IL)-1β pathway, leads to significant reductions in recurrent cardiovascular events.1

Vascular Diseases


ridker-paul-2018-congress-news.jpgImportantly, reductions in cardiovascular events were of a similar magnitude to those seen following aggressive low-density lipoprotein cholesterol (LDL-C) lowering with proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. We now know

that LDL-C lowering and inflammation inhibition are completely independent and results from CANTOS, the first trial to specifically target inflammation, represent a remarkable advance in the atherosclerosis research world.

Since ESC Congress 2017, the cardiovascular benefit of canakinumab has been shown to be directly related to the magnitude of inflammation reduction measured by on-treatment high-sensitivity C-reactive protein levels.2 Further to this, analyses on the relationship between the magnitude of canakinumab benefit and on-treatment levels of IL-6 have been conducted and will be presented as a Clinical Trial Update today (11.00 – 12.30 in Brahms – The Hub) and simultaneously published in the European Heart Journal.

“The initial CANTOS findings have opened the floodgates to a wide range of new investigations.”

The striking effect of IL-1β inhibition on lung cancer incidence has also been further evaluated3 and investigations are ongoing to understand how these cancer-lowering effects may be integrated into anti-cancer treatment regimens. In another particularly interesting observation, canakinumab demonstrated reductions in cardiovascular events among patients with chronic kidney disease, a group at very high risk in whom LDL-C lowering appears ineffective and in whom inflammation likely plays an important role in accelerated atherosclerosis.4 Further studies of canakinumab in patients with severe renal failure or dialysis are planned.

Over the past year, the CANTOS Investigator Group has been able to present updates that have made researchers re-evaluate many mechanisms of disease. A year on, data from CANTOS continues to have wide implications for both clinical care and the future of atherosclerosis research.

  1. Ridker PM, et al. N Engl J Med. 2017;377:1119–1131.
  2. Ridker PM, et al. Lancet. 2018;391:319–328.
  3. Ridker PM, et al. Lancet. 2017;390:1833–1842.
  4. Ridker PM, et al. J Am Coll Cardiol. 2018;71:2405–2414.

 

Don’t miss!

New data from CANTOS in the ‘Innovative strategies for secondary prevention’ session (08.30 – 10.00 in Minsk – Spotlight Village) and in the ‘Clinical Trial Updates’ session (11.00 – 12.30 in Brahms – The Hub).

Click here to read other scientific highlights in the ESC Congress news.

Notes to editor

About the European Society of Cardiology

The European Society of Cardiology brings together healthcare professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2018

ESC Congress is the world’s largest and most influential cardiovascular event contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2018 takes place 25 to 29 August at the Messe München in Munich, Germany. Explore the scientific programme