CANTOS: Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Title: Canakinumab for Atherosclerotic Disease

Design: Randomized, double-blind, placebo-controlled, event-driven phase 3 trial

Objective: To assess if canakinumab (Ab against interleukin-1β) reduce the recurrence CV events in patients with a history of MI and hs-CRP ≥ 2mg/L.

N=10,061

Year of publication: 2017

Inclusion Criteria: patients (age ≥ 18) with history of MI in prior 30 days and hsCRP of ≥2 mg/L. > (results only for 150 mg)

Comparison groups: Canakinumab, 150 mg (n=2,284) vs placebo (n=3,344)

Primary Outcome:

  • Primary Outcome Myocardial infarction, stroke, or CV death (per 100 person-yr) 3.86 vs 4.5 HR 0.85; 95% CI 0.74–0.98; P=0.02

Secondary Outcome:

  • MI, stroke, hospitalization for UA that led to unplanned revascularization, or CV death HR 0.83; 95% CI 0.73–0.95; 4.29 vs 5.13 P=0.005
  • MI, stroke, or death from any cause HR 0.85; 95% CI 0.75–0.96; 4.77 vs 5.56 P=0.01

Conclusion: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo.

Source: Ridker PM, et al. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. NEJM 2017. 377(12):1119-1131.