This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages without signing in

Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) trial

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) trial

Canakinumab targets IL-1beta, a highly specific mediator of inflammation

  • the IL-1 pathway has considerable preclinical data to support its involvement in atherogenesis
    • atherogenesis can be described as an inflammatory processs that leads to lipid accumulation in monocyte-derived macrophages that become foam cells

  • CANTOS investigators tested the hypothesis that inhibiting the action of the cytokine interleukin-1 (IL-1) beta would have beneficial effects on a composite endpoint in patients with a prior myocardial infarction and a high-sensitivity C-reactive protein (hsCRP) level that constituted a vascular risk (=2 mg/L) (2)
    • three different doses of the IL-1 beta neutralising antibody Canakinumab were tested against placebo over 48 months
      • trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death.

    • a dose-dependent reduction in hsCRP was demonstrated without significant alteration in lipid levels
      • Canakinumab did not reduce lipid levels from baseline

      • there was a dose graded reduction in the primary endpoint of first occurrence of nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death with the pre-specified, complex statistical threshold for primary and secondary endpoints being met with the 150-mg dose. There was no difference in all-cause mortality, however, there was a significant increase in infection-related deaths when all treated patients were compared with placebo

      • the study authors concluded "Antiinflammatory therapy targeting the interleukin-1ß 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, independent of lipid-level lowering"

Reference:


Related pages

Create an account to add page annotations

Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.