“This requirement, not routine in osteoarthritis trials, may have identified a subgroup of persons with osteoarthritis in whom inflammatory cytokines activate pathways that accelerate joint degeneration,” they write.
They note that based on current understanding of OA pathophysiology, IL-1 is a key player in both cartilage degradation and the enhancement of joint pain and these results “may offer promise for IL-1 inhibition as a treatment.”
“Further studies should evaluate the importance of elevated CRP levels as a factor affecting response to treatment, include more women to better reflect the osteoarthritis population, explore how to minimize infections, and try to better define the duration of therapy needed to detect treatment effects,” Drs. Lane and Felson conclude.
The CANTOS trial was supported by Novartis Pharmaceuticals. Dr. Ridker and several coauthors have disclosed financial relationships with the company.
References
- Schieker M, Conaghan PG, Mindeholm L, et al. Effects of interleukin 1β inhibition on incident hip and knee replacement: Exploratory analyses from a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2020 Aug 4. Online ahead of print.
- Lane N, Felson D. A promising treatment for osteoarthritis? Ann Intern Med. 2020 Aug 4. Online ahead of print.
