Frailty is a common condition in older populations that increases the risk of adverse health outcomes and mortality. Inflammation, associated with other aging-related conditions, has been proposed as one possible underlying mechanism for frailty. It was previously unclear if anti-inflammatory medications like canakinumab can also reduce risk of frailty.
Researchers led by a team at Brigham and Women’s Hospital, a founding member of the Mass General Brigham healthcare system, tested if canakinumab affected frailty incidence in adults with atherosclerosis.
The investigators performed post-hoc analysis on a dataset from the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS) to examine the effects of the medication on frailty, self-reported functional ability and cardiovascular events. The multinational, double-blind trial involved almost 10,000 stable post-myocardial infarction patients who were randomly allocated to receive either canakinumab or placebo every three months from 2011-2017.
During the trial, 1,080 patients became frail over a period of five years. The post-hoc analysis by the researchers did not find an effect of random allocation of canakinumab on frailty incidence or self-reported function. In addition, frailty status did not affect the relative efficacy of canakinumab for preventing cardiovascular events.
The study was limited to patients with atherosclerosis and does not include those without cardiovascular diseases. The authors suggest that it is possible that frailty in these participants could develop independent of canakinumab-affected pathways.
“It’s still unclear whether inflammation is a bystander or a causal factor in the development of frailty,” said corresponding author Ariela Orkaby, MD, MPH, of the Division of Aging. “More randomized trials with anti-inflammatory medications will help understand their role in preventing frailty and functional decline in older adults.”
Read more in Aging Cell.
Journal
Aging Cell
Method of Research
Experimental study
Subject of Research
People
Article Title
Effect of canakinumab on frailty: A post hoc analysis of the CANTOS trial
Article Publication Date
5-Nov-2023
COI Statement
Novartis funded the CANTOS trial and the statistical analyses conducted for this manuscript. This post-hoc analysis was investigator initiated. The funders approved the manuscript but were not otherwise involved in the conduct of this study. Dr. Orkaby is funded by VA CSR&D CDA-2 award IK2-CX001800 and reports consulting fees from Anthos Therapeutics. Ms. MacFadyen reports grants from Novartis during the conduct of the study. Dr. Ridker served as the Principal Investigator of the CANTOS trial which was funded by Novartis. Dr. Ridker has received institutional research grant support from Novartis, Kowa, Amarin, Pfizer, Esperion, NovoNordisk, and the NHLBI; has served as a consultant to Novartis, Flame, Agepha, AstraZeneca, Janssen, Civi Biopharm, Glaxo Smith Kline, SOCAR, Novo Nordisk, Omeicos, Health Outlook, Montai Health, New Amsterdam, Boehringer-Ingelheim, RTI; Zomagen, Cytokinetics, Horizon Therapeutics, and Cardio Therapeutics; has minority shareholder equity positions in Uppton, Bitteroot Bio, and Angiowave; and receives compensation for service on the Peter Munk Advisory Board (University of Toronto), the Leducq Foundation, Paris FR, and the Baim Institute (Boston, MA).