When Anti‑Inflammatory Heart Drugs Don’t Work: What the Trials Tell Us

Inflammation has been proposed as a key driver of atherosclerosis, and some trials have supported that idea while others have not. In 2017 the CANTOS trial tested canakinumab, an antibody that blocks interleukin-1β, and it reduced rates of some major cardiovascular events in people with prior heart attacks and high hsCRP. Since then, other studies have produced mixed results. The CIRT trial tested low‑dose methotrexate and did not lower cardiovascular events, and earlier drugs such as darapladib also failed to show benefit in large trials. These outcomes suggest that targeting inflammation is complex and patient selection matters.

More recently, in July 2026 AstraZeneca and Ionis reported that eplontersen did not meet the primary endpoint in a Phase 3 trial for transthyretin-mediated amyloid cardiomyopathy, a different heart disease caused by protein build-up. Novo Nordisk’s ziltivekimab has lowered hsCRP and other markers in earlier studies, and the large ZEUS cardiovascular outcomes trial is testing whether IL-6 inhibition reduces events. Therefore, although some anti-inflammatory therapies have lowered biomarkers, not all have clearly reduced hard heart outcomes; researchers must refine who may benefit and which pathways to target.