Interleukin-6 Inhibition with Ziltivekimab for Atherosclerotic Disease.

In adults with atherosclerotic cardiovascular disease, chronic kidney disease, and high-sensitivity CRP ≥2 mg/L, ziltivekimab did not reduce 3-point MACE versus placebo (HR 0.99).

• Why it matters: Interleukin-6 is hypothesized to be a therapeutic target in this high-risk group, but it was unknown whether neutralizing it would lower adverse cardiovascular events.
• What they did: In a multinational double-blind randomized trial (1:1), 6376 participants received subcutaneous ziltivekimab 15 mg monthly or placebo, with MACE as the primary endpoint.
• The result: Ziltivekimab lowered free interleukin-6 and high-sensitivity CRP (median percent change differences -76 and -64 percentage points), yet MACE occurred in 17.6% vs 17.7% (P=0.84).

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