From CANTOS to COLCOT to COPS to LoDoCo2: What are the lessons from these trials with anti-inflammatory treatment, in particular those with colchicine, in patients with residual inflammatory risk?
Investigators of the LoDoCo2 trial present the design and the major findings of this trial which evaluated colchicine in patients with chronic coronary disease.
Lp(a) meeting Jeffrey Kroon presents his study on inflammatory mechanisms driving CV risk in patients with high Lp(a) levels and a potential new strategy to reduce atherogenesis in these patients.
Erin Bohula explains which determinants of residual CV risk we nowadays know and presents study results on how to target these.
AHA 2019 The COLCHICINE-PCI trial investigated whether a single dose of the anti-inflammatory agent colchicine, given prior to PCI, resulted in reduced vascular inflammation and myocardial injury after PCI.
AHA 2019 Pradhan was the discussant of the COLCOT trial. She put the results in the broader perspective of managing inflammation as a means to lower CV risk.
AHA 2019 Dr. Tardif summarizes the study design and results of the COLCOT trial, in which colchicine treatment was found to lower a composite endpoint in patients soon after MI.
CSI Paris Steven Hageman asks Cilie van 't Klooster about her study on the relationship between CRP levels and risk of incident cancer and recurrent CV events in subjects with stable CVD in the SMART-cohort.
Prof. Ray describes the high residual CV risk in post-ACS diabetes patients, and how BET inhibition with apabetalone may reduce this residual risk and thereby prevent CV events.
Prof. Libby discusses the inflammatory residual risk in diabetes patients and explains how epigenetic modulation of (inflammatory) gene transcription can potentially reduce CV risk.
During the last 30 years, clinical characteristics of HF patients have changed; nowadays, obesity is common in HF. Dr. Packer explains why obesity plays such an important role in HFpEF.
EAS 2019 Paul Ridker discusses the positive effect of canakinumab on, in particular, non-small cell lung cancer incidence and mortality, as demonstrated in the CANTOS trial.
AHA 2018 In the ANITSCHKOW study, patients with very high Lp(a) were treated with evolocumab 420 mg once monthly. The 14% lowering in Lp(a) was not sufficient to eliminate the inflammatory stimulans induced by Lp(a).
AHA 2018 Paul Ridker outlines how the new CIRT results add to our understanding of inflammation biology in relation to CV risk and how this directs future studies of inflammation.
ESC 2018 Biomarkers play an important role in CV risk prediction. Nina Paynter, PhD, presents the definition of a good biomarker and explains how deep learning can improve CV risk assessment.
Prof. Jorge Plutzky explains BET inhibition as a novel therapeutic strategy for controlling pathologic cardiovascular responses.
ESC 2018 Cilie van 't Klooster asks Prof. Ridker how the results on canakinumab from the CANTOS trial can be implemented in clinical practice and which challenges are left?
Professor Erik Stroes gives an overview of evidence that inflammation plays a role in CVD and diabetes and considers options to target the hyperactive inflammatory state to lower residual CV risk.
Prof. Paul Ridker discusses the insights that originate from the CANTOS trial, in which reducing inflammation with canakinumab reduced CV events. These findings have implications for the management of residual risk.
Prof. Libby discusses IL-1β as a target for atherosclerosis therapy, a strategy that was evaluated in the CANTOS trial, which tested the monoclonal antibody canakinumab.
ACC 2018 Due to the observed link between inflammation and aberrant insulin regulation, a key secondary outcomes of the CANTOS trial was new onset T2DM in patients with prediabetes at baseline.
ACC 2018 A new analysis of the CANTOS trial showed that IL-1β inhibition in patients with stage 3 kidney disease did not slow progression to renal failure, but did beneficially alter outcomes in these very high risk patients.
Prof. Libby explains the role of IL-1β in CV disease and the effects of antiinflammatory therapy targeting the IL-1β innate immunity pathway with canakinumab
Prof. Stroes describes the 3 pathways involved in progression of atherosclerosis and new algorithms to reduce residual risk with personalized therapy.
Prof. Wolfgang Koenig explains the role of inflammation in the atherogenic process and how to identify patients with residual inflammatory risk.
Professor Lam lists five mechanisms in which she recognizes targets for treatment of patients with heart failure with preserved ejection fraction. These mechanisms are currently tested as therapeutic strategies.
AHA 2017 A new analysis of CANTOS dived into which patients may benefit most of canakinumab treatment. Baseline characteristics did not help, but response to treatment did.
Inflammation Expert Opinions Il prof. Raffaele De Caterina spiega perché CANTOS è uno studio clinico importante. E’ il primo studio clinico che dimostra che un farmaco anti-infiammatorio influenza favorevolmente importanti eventi cardiovascolari, e pertanto può diventare una terapia da inserire nell’armamentario terapeutico in aggiunto agli attuali trattamenti.
Inflammation Expert Opinions Prof. Raffaele de Caterina explains why CANTOS is an important trial. It is the first trial showing that an anti-inflammatory drug can affect important CV outcomes and thus may be a convenient therapy in addition to current treatment strategies.
Inflammation Expert Opinions According to prof. Ulf Landmesser, the CANTOS trial shows that inflammation is crucial for disease progression and that targeting inflammation as a risk factor may have important implications for high-risk populations.
Inflammation Expert Opinions Prof. Ulf Landmesser: Die CANTOS Studie zeigt erstmalig, dass eine Interleukin-1 Beta Inhibition, d.h. eine spezifische Entzündungshemmung, das kardiovaskuläre Risiko nach akutem Koronarsyndrom reduzieren kann.
Inflammation Expert Opinions Prof. Wolfgang Koenig: Die CANTOS Studie belegt dass inflammatorische Prozesse eine kausale Rolle in der Atherogenese spielen. Inhibition der Inflammation führt zu einer weiteren Reduktion des kardiovaskulären Risikos ohne Beeinflussung des Lipidstatus.
Inflammation Expert Opinions Prof. Wolfgang Koenig states that the CANTOS trial shows that inflammation plays a causal role in the atherogenic process. Blocking this inflammation may be an additional treatment option beyond lipid lowering for CV risk reduction.
Inflammation Expert Opinions Lina Badimon explica por qué el bloqueo de la inflamación puede representar un beneficio clínico significativo, debido al importante papel de la inflamación en la formación de la placa aterosclerótica. Los resultados de CANTOS pueden representar el inicio de una nueva era en la prevención cardiovascular.
Inflammation Expert Opinions Lina Badimon explains why blocking inflammation may have significant clinical benefit, as inflammation is important in plaque formation. The results of CANTOS can be the dawn of a new era of CV prevention.
Inflammation Expert Opinions Erik Stroes summarizes the results from CANTOS and states that for daily clinical practice, it is important to select the major factors contributing to CV risk
Inflammation Expert Opinions Filippo Crea riflette su una pubblicazione del 1994, introducendo l’ ipotesi sull’infiammazione e spiega come lo studio CANTOS confermi tale ipotesi. La sfida ora è individuare i pazienti che trarranno beneficio da questo trattamento.
Inflammation Expert Opinions Prof Filippo Crea reflects on a publication from 1994, introducing the inflammatory hypothesis, and explains how the CANTOS trial confirms this hypothesis. The challenge is now to identify patients who will benefit from this treatment.
FRANCAIS Philippe Gabriel Steg réfléchit sur les résultats de l’étude CANTOS, qui soutient l’hypothèse que l’athérosclérose est une maladie chronique inflammatoire.
Inflammation Expert Opinions Philippe Gabriel Steg reflects on the CANTOS trial results that confirm the long-standing hypothesis that inflammation plays a role in CV events and he considers which questions remain to be answered before broad clinical application of this concept.
Inflammation Expert Opinions Paul Ridker and Peter Libby look back at the evolution of their research efforts on the role of inflammation in CV risk, and how they saw their hypothesis confirmed in the CANTOS trial.
ESC 2017 Peter Libby, who started basic research on the role of IL-1 in atherogenesis 30 years ago, gives his perspective on the CANTOS results, including the preliminary results that hint at a reduction in cancer fatalities.
ESC 2017 Paul Ridker shares what the results of the CANTOS trial mean to him as a clinician. Lowering inflammation by inhibiting IL-1β with canakinumab reduced CV events in aggressively treated CV patients.
VBWG ACC 2017 HIV-infected persons have increased CV risk. Even when HIV is adequately suppressed, chronic inflammation persists. Studying this condition can give insights in how to reduce CV risk and possibly HIV infection in these individuals.
Dr. Paul M. Ridker explains the concept of residual inflammatory risk. Currently, trials are investigating whether lowering inflammatory components might reduce CV event rates.
AHA 2016 The orally active epigenetic drug RVX-208 or apabetalone that alters gene activity by modifying chromatin structure, lowered the incidence of MACE in a phase 2b study. This effect could not entirely be attributed to an effect on HDL, explains dr. Norman Wong.
CSI ROME Nicole Jaspers and Manon Slob interview Prof. Paul Ridker about the concept of residual risk and how the different forms may be targeted with novel therapeutic strategies to further lower CV risk.
Paul Ridker, MD, explains the potential role of inflammation as a treatment target to reduce cardiovascular events.
ESC 2016 BET inhibition affects gene expression via epigenetic mechanisms. Jorge Plutzky explains how these mechanisms work and their possible role in cardiovascular disease.
This discussion combines the mechanistic insights into the inflammatory component in atherogenesis of Jon Laman with the clinical perspective of Wolfgang Koenig. They discuss how inflammation reseach may change CV treatment approaches in the future.
In patients with elevated LDL-c and CRP, adding another lipid-lowering therapy may not adequately lower CV risk. Targeting residual inflammatory risk may be an effective strategy for secondary prevention.
Peter Libby considers how the pathophysiology of atherosclerosis and the mechanisms of ACS are changing, as a result of preventive therapies and a change in risk factors, toward superficial erosion.
ACC 2016 Michelle O'Donoghue (Boston, MA, USA) shares the primary results of LATITUDE TIMI-60. Treatment with p38 MAP-kinase inhibitor losmapimod showed favourable effects on biomarkers, but did not improve the primary outcome in patients hospitalised for acute MI.
Prof. Peter Libby (Boston, MA, USA) discusses how views on mechanisms of ACS have changed over time and how traditional thoughts on plaque composition and vulnerability are now challenged. He proposes a new mechanism of coronary thrombosis that may cause ACS.
Prof. Ridker emphasises the importance of the inflammatory component of residual risk. Trials are currently addressing whether specifically targeting inflammatory residual risk can further reduce CV events in certain patients.
A mechanism of action video on the potential role of inflammation in atherothrombosis
Prof. Paul Ridker sets out how the hypothesised role for inflammation in atherosclerosis is now a pathway that can be targeted therapeutically. He consideres ongoing efforts to target the inflammatory response.
Professor Raffaele de Caterina shows that thrombosis is not only the indirect result of atherosclerosis, but can also be induced by inflammation directly.
ISA 2015 Prof. Peter Libby recapitulates evolving insights into the mechanism of acute coronary syndromes, and how we may be shifting from a predominance of plaque ruptures towards superficial erosion as the cause of ACS.
Prof Peter Libby, Boston, USA, discusses the implications of recent insights in inflammation in atherosclerosis with Göran Hansson, Stephen Nicholls and Paul Ridker.
Dr. Paul Ridker, Boston, describes the different inflammatory pathways and ongoing clinical trials targeting inflammation
Raphael Duivenvoorden, Amsterdam, describes an innovative nanotechnique to reduce the risk of a recurrent myocard infarct, in which inflammation is a key factor.
Prof. Ulf Landmesser provides an overview of the targets for intervention in the inflammatory process in cardiovascular disease.
The symposium Inflammation & cardiovascular disease: Exploring new options for intervention was held at the congress of the European society of Cardiology (ESC) in Amsterdam on September 2, 2013. Videopresentations from the lectures by Peter Libby, Wolfgang Koenig and Peter Ridker are now available on this website.