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Review
. 2019 Oct;42(10):942-951.
doi: 10.1002/clc.23246. Epub 2019 Aug 15.

Interleukin-1 blockade treatment decreasing cardiovascular risk

Zi-Heng Zheng  1 , Xun Zeng  1   2 , Xiao-Ying Nie  1   2 , Yun-Jiu Cheng  1 , Jun Liu  1 , Xiao-Xiong Lin  1 , Hao Yao  1 , Cheng-Cheng Ji  1 , Xu-Miao Chen  1 , Fan Jun  1 , Su-Hua Wu  1
Affiliations
Review

Interleukin-1 blockade treatment decreasing cardiovascular risk

Zi-Heng Zheng et al. Clin Cardiol. 2019 Oct.

Abstract

Background: Interleukin-1 (IL-1) played a role in the occurrence and development of atherosclerosis and cardiovascular events. However, the association between IL-1 blockage treatment and reducing of cardiovascular risk remains poorly defined.

Hypothesis: IL-1 blockage treatment reduce the risk and incidence rate of overall major adverse cardiovascular events (MACE), all-cause death, acute myocardial infarction(MI), unstable angina and heart failure.

Methods: We performed a search of published reports by using MEDLINE database (January 1, 2005 to April 1, 2018). The randomized controlled trials (RCTs) that reported sample size and occurrence numbers in test group and placebo group for the associations of interest were included.

Results: Eight RCT studies involving 15 647 participants were identified. Compared with those who took no IL-1 blockage, patients taking IL-1 blockage experienced a decreased risk of overall MACE (RR 0.88, 95% CI 0.82-0.94), unstable angina (RR 0.80, 95% CI 0.66-0.98), and breakthrough or recurrence of heart failure (RR 0.44, 95% CI 0.22-0.87). No association was found between IL-1 blockage treatment and death from all cause (RR 0.91, 95% CI 0.83-1.00) as well as acute MI (RR 0.85, 95% CI 0.71-1.01). The RRs associated with overall MACE, death from all cause, acute MI, and unstable angina for anakinra were 1.05, 1.16, 2.97, and 0.56, respectively, and for canakinumab were 1.05, 0.91, 0.80, and 0.80, respectively.

Conclusions: Administration of IL-1 blockage was associated with decrease risks of overall MACE, unstable angina, and breakthrough or recurrence of heart failure, but not with death from all cause as well as acute MI.

Keywords: Interleukin-1 blockade; anakinra; canakinumab; cardiovascular events; meta-analysis.

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Figures

Figure 1
Figure 1
Flowchart of the selection of studies included in meta‐analysis
Figure 2
Figure 2
Interleukin‐1 Blockade treatment and Cardiovascular Risk. The dotted line in the forest plot represents fixed‐effects summary risk estimate
Figure 3
Figure 3
Forest plot showing relative risks of overall major adverse cardiovascular events, death from any cause, acute myocardial Infarction, unstable angina and breakthrough or recurrence of heart failure. The size of each square is proportional to the study's weight (inverse of variance). The dotted line in the forest plot represents fixed‐effects summary risk estimate
Figure 4
Figure 4
Forest plot showing result of by subgroup analysis by investigational drug about relative risks of overall major adverse cardiovascular events, death from any cause, acute myocardial Infarction, unstable angina. The size of each square is proportional to the study's weight (inverse of variance). The dotted line in the forest plot represents fixed‐effects summary risk estimate
See this image and copyright information in PMC

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