"Anti-inflammatory Therapies in Atherosclerosis - Where are we going?"

IF 5.7 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Atherosclerosis Reports Pub Date : 2024-12-19 DOI:10.1007/s11883-024-01267-7
Natdanai Punnanithinont, Soumya Kambalapalli, Beshoy Iskander, Keishi Ichikawa, Srikanth Krishnan, Suvasini Lakshmanan, Sion K Roy, Matthew Budoff
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Abstract

Purpose of review: Inflammation has been commonly known for the past decade as a part of the pathophysiology of atherosclerosis, along with lipid accumulation. However, some patients with optimized lipid-lowering therapy still have elevated inflammatory biomarkers. Anti-inflammation therapies were developed to eradicate this residual risk. We summarized the primary inflammatory pathway and recent clinical trials in anti-inflammation therapies.

Recent findings: Colchicine Cardiovascular Outcomes Trial (COLCOT) and LoDoCo2 (Colchicine Reduces Risk of Major Cardiovascular Events in Chronic Coronary Disease) found that low-dose colchicine significantly reduced cardiovascular death, myocardial infarction (MI), ischemic stroke and coronary revascularization in patients with recent MI within 30 days and chronic coronary disease respectively. The US Food and Drug Administration approved low-dose colchicine in 2023 for patients with established atherosclerotic cardiovascular disease (ASCVD). However, its use was limited for chronic kidney disease (CKD) patients. Reduction in Inflammation in Patients with Advanced Chronic Renal Disease Utilizing Antibody Mediated Interleukin-6 Inhibition (RESCUE) was conducted using Ziltivekimab, an IL-6 ligand monoclonal antibody and found that it significantly reduced high-sensitivity C-reactive protein, an inflammatory surrogate marker. There is an ongoing phase-3 clinical trial, Ziltivekimab Versus Placebo Cardiovascular Outcomes in Participants with Atherosclerotic Cardiovascular Disease, Chronic Kidney Disease, and Systemic Inflammation trial (ZEUS), which will be essential for further anti-inflammation therapy for patients with CKD. Numerous clinical trials have investigated anti-inflammation therapies. Colchicine is by far the only one that has the potential to be widely used due to its cost-effectiveness. Further research is needed on other novel anti-inflammation therapies and their real-world implementation.

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“动脉粥样硬化的抗炎治疗——我们将走向何方?”
回顾目的:在过去的十年中,炎症已经被普遍认为是动脉粥样硬化的病理生理的一部分,与脂质积累一起。然而,一些优化的降脂治疗的患者仍然有升高的炎症生物标志物。抗炎症疗法被开发出来以消除这种残余风险。我们总结了主要的炎症途径和最近的抗炎治疗的临床试验。近期发现:秋水仙碱心血管结局试验(COLCOT)和LoDoCo2(秋水仙碱降低慢性冠状动脉疾病主要心血管事件的风险)发现,低剂量秋水仙碱分别显著降低最近30天内心肌梗死(MI)和慢性冠状动脉疾病患者的心血管死亡、心肌梗死(MI)、缺血性卒中和冠状动脉血管重建术。美国食品和药物管理局于2023年批准了低剂量秋水仙碱用于已建立的动脉粥样硬化性心血管疾病(ASCVD)患者。然而,它在慢性肾脏疾病(CKD)患者中的应用受到限制。利用抗体介导的白介素-6抑制(IL-6配体单克隆抗体Ziltivekimab)减少晚期慢性肾脏疾病患者的炎症,发现它可以显著降低炎症替代标志物高敏c反应蛋白。有一项正在进行的iii期临床试验,Ziltivekimab与安慰剂在动脉粥样硬化性心血管疾病、慢性肾脏疾病和全身性炎症患者中的心血管结局试验(ZEUS),这将对CKD患者的进一步抗炎症治疗至关重要。许多临床试验研究了抗炎症疗法。秋水仙碱是迄今为止唯一一种由于其成本效益而具有广泛应用潜力的物质。需要进一步研究其他新的抗炎症疗法及其在现实世界中的应用。
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来源期刊
CiteScore
9.00
自引率
3.40%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
期刊最新文献
Striving Towards Equity in Cardiovascular Genomics Research. Sex-based Differences in Complications Following Percutaneous Coronary Interventions. Achieving More Optimal Lipid Control with Non-Statin Lipid Lowering Therapy. Leveraging Mobile Health and Wearable Technologies for the Prevention and Management of Atherosclerotic Cardiovascular Disease. Highlights of Cardiovascular Disease Prevention Studies Presented at the 2024 American Heart Association Scientific Sessions.
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