Blocking inflammation does not always protect the heart
Chronic inflammation is a well-known risk factor for heart disease. So reducing inflammation should protect the heart. That was the reasoning. A major new trial shows the reasoning does not hold.
Novo Nordisk tested an experimental anti-inflammatory drug called ziltivekimab in more than 6,300 people with heart disease, kidney disease and elevated inflammation. In theory, an ideal target population. The drug did reduce inflammation, as measured by blood markers. But clinical outcomes did not improve.
Inflammation drops, risk does not
The rate of heart attacks, strokes and cardiovascular deaths did not differ significantly between the ziltivekimab group and the control group. That is the conclusion from Novo Nordisk’s Phase 3 study. The researchers reported their findings via STAT News.
This is a significant blow to the hypothesis that blocking inflammation through this specific mechanism is sufficient to prevent cardiac events. The approach was not new: earlier drugs targeting different inflammatory pathways had succeeded. It appears that what matters is not inflammation in general, but which inflammatory pathway you block.
What does this mean for longevity?
Chronic low-grade inflammation (inflammaging) is one of the central concepts in ageing research. The idea that suppressing this smouldering inflammation can slow ageing and its associated diseases underpins countless studies and products. This result calls for caution.
Not all inflammation is the same, and not every anti-inflammatory drug actually prevents heart disease. Ziltivekimab targets a specific protein in the immune response (IL-6). Earlier drugs that did succeed in cardiovascular disease targeted a different protein (IL-1β). That distinction, it turns out, matters in practice.
For those hoping that broad anti-inflammation will serve as an ageing intervention, this is a useful reminder: the mechanism behind the inflammation counts. More evidence and greater precision are needed before anti-inflammatory treatment can be recommended as a standard longevity intervention.
Search terms to explore further: inflammaging cardiovascular risk, IL-6 inhibition heart disease clinical trial, anti-inflammatory therapy ageing