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Canakinumab for secondary prevention of atherosclerotic disease

机译：Canakinumab用于继发性动脉粥样硬化疾病

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Introduction: The widespread prevalence of cardiovascular disease (CVD) and its impact on morbidity and mortality requires effective secondary prevention measures. For years, inflammation has been advocated as a key mediator of atherosclerosis and its associated complications. Drugs for secondary prevention of CVD events include interventions aimed at risk factors control and antithrombotic management, but there is no drug currently recommended that specifically targets inflammation. Recently, the inflammatory hypothesis of atherosclerosis has been confirmed by a randomized clinical trial of canakinumab, a monoclonal antibody that blocks an inflammatory pathway mediated by interleukin-1? Areas covered: This article reviews the pharmacology of canakinumab, its current clinical development status and upcoming regulatory perspectives. Expert opinion: In the CANTOS trial, canakinumab 150 mg met the pre-specified criteria of statistical significance, showing a reduction in combined cardiovascular events, myocardial infarction, re-hospitalization due to urgent revascularization and any coronary revascularization, but no impact on all-cause or cardiovascular death. There were more death attributed to sepsis or infection with canakinu-mab than placebo, but fewer reports of arthritis, gout, osteaoarthritis and cancer-related death. Because interleukin-1?is only one of the potential pro-inflammatory pathways that may serve as a target for atherothrombotic protection, other anti-inflammatory drugs may be the object of future investigations. If approved, the initial penetration of canakinumab will face hurdles in view of cost issues, but costs are likely to decrease if the drug loses its present status of orphan drug with the new indication.
机译：介绍：心血管疾病（CVD）的普遍普遍性及其对发病率和死亡率的影响需要有效的二级预防措施。多年来，炎症被倡导为动脉粥样硬化的关键介质及其相关并发症。用于次要预防CVD事件的药物包括旨在危险因素的干预措施控制和抗血栓性管理，但目前没有药物推荐特异性靶向炎症。最近，通过Canakinumab的随机临床试验证实了动脉粥样硬化的炎症假设，一种阻断由白细胞介素-1介导的炎症途径的单克隆抗体？所涵盖的地区：本文审查了加拿大尼亚布的药理学，其目前的临床发展状况和即将到来的监管观点。专家意见：在Canakinumab中，Canakinumab 150 Mg符合预先规定的统计学标准，表明组合心血管事件，心肌梗塞，因急诊血运重建和任何冠状动脉血运重建而重新住院，但对所有人没有影响原因或心血管死亡。患有败血症或用Canakinu-Mab感染的死亡归因于安慰剂，但较少的关节炎，痛风，骨关节炎和与癌症相关死亡的报道较少。因为白细胞介素-1？只是可能用作动脉粥样硬化保护的靶标的潜在促炎途径之一，其他抗炎药可能是未来调查的目的。如果批准，山茱萸的初始渗透率将面临障碍，鉴于成本问题，如果药物随着新迹象，药物失去其目前的孤儿药状态，可能会降低成本。

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