Anti-inflammatory medication does not reduce frailty risk in adults with atherosclerosis

Frailty is a common condition in older populations that increases the risk of adverse health outcomes and mortality. Inflammation, associated with other aging-related conditions, has been proposed as one possible underlying mechanism for frailty. It was previously unclear if anti-inflammatory medications like canakinumab can also reduce risk of frailty.

Researchers led by a team at Brigham and Women's Hospital, a founding member of the Mass General Brigham healthcare system, tested if canakinumab affected frailty incidence in adults with atherosclerosis.

The investigators performed post-hoc analysis on a dataset from the Canakinumab Anti-Inflammatory Thrombosis Outcomes Study (CANTOS) to examine the effects of the medication on frailty, self-reported functional ability and cardiovascular events. The multinational, double-blind trial involved almost 10,000 stable post-myocardial infarction patients who were randomly allocated to receive either canakinumab or placebo every three months from 2011-2017.

During the trial, 1,080 patients became frail over a period of five years. The post-hoc analysis by the researchers did not find an effect of random allocation of canakinumab on frailty incidence or self-reported function. In addition, frailty status did not affect the relative efficacy of canakinumab for preventing cardiovascular events.

The study was limited to patients with atherosclerosis and does not include those without cardiovascular diseases. The authors suggest that it is possible that frailty in these participants could develop independent of canakinumab-affected pathways.

It's still unclear whether inflammation is a bystander or a causal factor in the development of frailty. More randomized trials with anti-inflammatory medications will help understand their role in preventing frailty and functional decline in older adults."

Ariela Orkaby, MD, MPH, corresponding author, Division of Aging