Canakinumab for secondary prevention of coronary artery disease

Future Cardiol. 2021 May;17(3):427-442. doi: 10.2217/fca-2020-0211. Epub 2021 Feb 3.

Abstract

Cardiovascular disease manifestations (CVD) are the world's leading cause of death, and their impact on morbidity requires effective prevention strategies of recurrent adverse events. For decades, inflammation has been proposed as a key promoter for atherosclerosis and its complications. However, studies on the use of drugs to target the excess inflammation in CVD are limited. In 2017, the Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS) trial confirmed the key role of inflammation on atherosclerotic disease. Canakinumab is a monoclonal antibody that blocks an inflammatory pathway mediated by IL-1β. The results of the CANTOS trial opened a new era of investigating new therapeutics targeting inflammation for CVD secondary prevention. This review presents the canakinumab's pharmacology, current clinical development status and regulatory perspectives.

Keywords: IL-1β; canakinumab; inflammation.

Plain language summary

Lay abstract Cardiac and vascular conditions (CVD) are the world's leading cause of death, and their impact on medical conditions requires effective prevention strategies of repeated complications. For decades, inflammation has been proposed as a key protagonist of CVD, a disease produced by the narrowing of the coronary arteries, peripheral arteries, and its complications. However, studies on the use of medications to treat the excess of inflammation in CVD are limited. In 2017, the Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS) study confirmed the key role of inflammation on CVD. Canakinumab is a protein made in the laboratory that can block inflammatory reactions in the body, mediated by a potent pro-inflammatory protein called IL-1β. The CANTOS study results opened a new era of research for CVD secondary prevention targeting several substances related to inflammation. This manuscript analyzes the currently available scientific data of canakinumab, focusing on the drug characteristics and medical application to treat CVD.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized
  • Atherosclerosis* / drug therapy
  • Atherosclerosis* / prevention & control
  • Coronary Artery Disease* / drug therapy
  • Coronary Artery Disease* / prevention & control
  • Humans
  • Secondary Prevention

Substances

  • Antibodies, Monoclonal, Humanized
  • canakinumab