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Canakinumab Explored as Therapy for Large-Joint Osteoarthritis

MONDAY, Aug. 3, 2020 -- Inhibition of interleukin-1β (IL-1β) with canakinumab seems to reduce the incidence of total hip replacement/total knee replacement (THR/TKR) compared with placebo, according to an exploratory analysis published online Aug. 4 in the Annals of Internal Medicine.

Matthias Schieker, M.D., from the Novartis Institutes for Biomedical Research in Cambridge, Massachusetts, and colleagues examined whether IL-1β inhibition with canakinumab reduces incident total hip or knee replacement using datafor 10,061 participants with large-joint osteoarthritis from the Canakinumab Anti-inflammatory Thrombosis Outcomes Study, which was conducted at 1,091 clinical sites in 39 countries. Participants were randomly assigned to placebo or canakinumab (50, 150, and 300 mg) subcutaneously every three months and were followed for a median of 3.7 years.

The researchers found that the hazard ratios for incident THR/TKR during follow-up were 0.60, 0.53, and 0.60 for the 50-, 150-, and 300-mg canakinumab dose groups, respectively, compared with placebo. Compared with the placebo group, in the pooled canakinumab group, the incidence rates for THR/TKR were 0.31 and 0.54 events per 100 person-years, respectively (hazard ratio, 0.58). For the secondary end point of osteoarthritis-related adverse events, the hazard ratio was 0.73.

"This research is particularly relevant because large joint osteoarthritis is an increasingly common disorder with few effective and tolerated therapies other than joint replacement surgery, and for which no precision medicine structure-modifying drugs are currently available," the authors write.

The trial was funded by Novartis Pharmaceuticals.

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Posted: August 2020

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