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Novel anti-inflammatory strategies in atherosclerosis

van der Valk, Fleur M.; van Wijk, Diederik F.; Stroes, Erik S.G.

doi: 10.1097/MOL.0b013e3283587543
THERAPY AND CLINICAL TRIALS: Edited by Anton F. Stalenhoef and John Kastelein
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Purpose of review Inflammation has been widely acknowledged to contribute throughout all stages of atherogenesis. However, these recent advances in our understanding have not been translated into clinical practice in which the mainstay of treatment is still lipid-targeted therapy. This review provides an overview of promising anti-inflammatory therapies in atherosclerosis, and discusses potential drawbacks and clinical benefits.

Recent findings Immunosuppressive drugs are likely to beneficially affect atherogenesis. Several novel anti-inflammatory targets have been scrutinized, of which some have reached clinical development stage, such as cytokine targets interleukin-1 and interleukin-6, CCR2 antagonist, selective phospholipase, and leukotriene inhibitors. Novel imaging modalities such as MRI and PET-computed tomography provide valuable surrogate inflammatory endpoints for risk stratification and testing anti-inflammatory agents in cardiovascular randomized trials.

Summary Anti-inflammatory therapies hold great promise in cardiovascular prevention regimens; however, atherosclerosis is a chronic disease, and systemic long-term use of anti-inflammatory agents carries the risk of complications arising from immunosuppression. In order to successfully add immunosuppressive drugs to our routine armament, we need to identify high-risk patients who benefit from anti-inflammatory treatment, increase our insight into the inflammatory pathogenesis of atherogenesis, and find safe and effective compounds capable of directly suppressing plaque inflammation.

Academic Medical Center, Amsterdam, The Netherlands

Correspondence to Fleur M. van der Valk, MD, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. Tel: +31 20 5668791; e-mail: f.m.valkvander@amc.nl

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.