News: Several trials ongoing targeting inflammation after AMI

According to a clinical review published in the Journal of the American College of Cardiology, atherosclerotic cardiovascular disease remains a leading cause of morbidity and mortality worldwide, with acute myocardial infarction (AMI) as the primary contributor to cardiovascular death. Despite advances in secondary prevention, adverse cardiovascular events continue to occur after AMI. Inflammation has a complex but increasingly recognized role as a determinant of this residual risk, Medscape Medical News reported.

Recent studies suggest that acute and persistent inflammation is a stronger predictor of recurrent events and mortality than low-density lipoprotein cholesterol. The review states that modulating inflammation has emerged as a promising secondary prevention strategy, and several drugs are currently being tested with conflicting results regarding their efficacy and safety.

The drug classes that are more advanced in clinical development include:

• Inhibitors of tubulin polymerization which disrupt microtubule function and therefore attenuate neutrophil activation
• Drugs targeting the IL-1 pathway which block IL-1 signaling to reduce the downstream inflammatory cascade
• Drugs targeting the IL-6 pathway which modulate IL-6 signaling, a key driver of systemic inflammation
• Pleiotropic inflammation modulators which have broader effects on inflammatory pathways

The clinical review also covers safety considerations in anti-inflammatory therapy, as well as patient selection, timing, and dosing of anti-inflammatory therapy of AMI. Although several studies have demonstrated that reducing systemic inflammation may lead to improved cardiovascular outcomes, the clinical review states that key questions remain about the specific inflammatory pathways involved, the patient populations most likely to benefit, the timing and duration of therapy, and the long-term safety of anti-inflammatory interventions.

Editor’s note: To read Medscape Medical News’ coverage of this story, click here. To read the full clinical review, click here.