News: Winter 2018

Inflammation and Disease: Brigham Breakthrough Rocks CV Community

A new analysis seeks to answer the question of which patients are likely to gain the greatest cardiovascular benefit when treated with the anti-inflammatory agent canakinumab. At the 2017 American Heart Association Scientific Sessions, Paul Ridker, MD, director of the BWH Center for Cardiovascular Disease Prevention presented the groundbreaking results of his 10,000+ patient study that identifies new patient selection methods to optimize effectiveness and a means of using anti-inflammatory agents for cardiovascular disease.

“We believe the clinical approach of targeting treatment to those who truly benefit on the basis of biologic response represents an elegant step toward personalized medicine and rational resource utilization,” said Ridker. “Figuring out which patients with residual inflammatory risk benefit the most will allow us to get the right drug to the right patient, greatly reducing costs as well as hazards.”

The trial was designed to test whether canakinumab, which lowers inflammation independent of lipid levels, could reduce risk of a future cardiovascular event by reducing inflammation among people who have had a prior heart attack and who have persistently elevated levels of the inflammatory biomarker high-sensitivity C-reactive protein (hsCRP) despite aggressive care.

“This incredibly impactful study is the culmination of years of pre-clinical and translational research by Brigham investigators that have established a key role for inflammation in cardiovascular disease, cancer, and possibly other maladies,” said Paul Anderson, MD, PhD, BWH Chief Academic Officer. “Given the overall strength of the Brigham in these areas of research, these findings will likely be translated into new therapies for our patients.”

In the new analysis, the team found that baseline characteristics did not modify the effect of canakinumab on clinical outcomes. However, the magnitude of decrease in hsCRP with canakinumab related directly to the magnitude of clinical benefit associated with continued long-term therapy.

In commenting on the commercial implication, Pat Fortune, PhD, Vice President, Market Sectors, Partners Innovation commented “the opportunity is to develop drugs to treat chronic inflammation, a root or contributing cause of disorders from cancer to cardiovascular disease to neurological disease,” This means that this discovery is of interest to virtually every pharmaceutical company developing drugs in a large number of therapeutic areas.”

The study has implications for patient selection, cost-effectiveness and drug design and development going forward, with the potential to increase canakinumab’s benefit to risk ratio.

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“This incredibly impactful study is the culmination of years of pre-clinical and translational research by Brigham investigators that have established a key role for inflammation in cardiovascular disease, cancer, and possible other maladies. Given the overall strength of the Brigham in these areas of research, these findings will likely be translated into new therapies for our patients.”
– Paul Anderson