Given that subclinical inflammation is involved in the pathology of peripheral insulin resistance and impaired pancreatic insulin secretion, the CANTOS trial investigators analysed whether canakinumab (an IL-1β inhibitor) reduced the rate of incident diabetes mellitus. Of the 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level ≥2 mg/l enrolled in the trial, 40.3% had diabetes at baseline, 49.3% had prediabetes, and 10.4% were normoglycaemic. Over 3.7 years of follow-up in those without diabetes at baseline, canakinumab did not reduce the incidence of new-onset diabetes compared with placebo (HR 1.02, 95% CI 0.87–1.19). Nevertheless, IL-1β inhibition was similarly effective in reducing the rate of major adverse cardiovascular events in patients with or without diabetes.
References
Everett, B. M. et al. Anti-inflammatory therapy with canakinumab for the prevention and management of diabetes. J. Am. Coll. Cardiol. https://doi.org/10.1016/j.jacc.2018.03.002 (2018)
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Lim, G. No benefit of canakinumab in diabetes prevention. Nat Rev Cardiol 15, 256 (2018). https://doi.org/10.1038/nrcardio.2018.32
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DOI: https://doi.org/10.1038/nrcardio.2018.32