New Promises and Challenges on Inflammation and Atherosclerosis: Insights From CANTOS and CIRT Trials

Atherosclerosis is still a great burden on human health and scientific achievements of the past 30 years have definitively proven the inflammatory causes of the disease (1, 2) highlighted by the results of the CANTOS trial (3). Canakinumab inhibition of interleukin-1 (IL1)-beta has been demonstrated to provide protection against cardiovascular (CV) risk irrespective of lipid levels in a cohort of patients with high C–reactive protein (CRP) levels despite achieving blood lipid control, as measured by high sensitivity C-Reactive Protein (hsCRP) (3). The final demonstration of atherosclerosis as an inflammatory-driven pathology is driving research toward new anti-inflammatory approaches that could influence the natural history of the disease and change the clinical paradigms of therapy. Considering the costs of canakinumab and exploiting different avenues of anti-inflammatory therapies, a more affordable approach has been proposed by the authors of the CANTOS study (4).