Effect of Inflammasome Inhibitor on hsCRP in Patients After PCI
Status:
Recruiting
Trial end date:
2022-04-30
Target enrollment:
Participant gender:
Summary
Coronary artery disease (CAD) comprises the major contributor to a global epidemic of
cardiovascular disease. Patients with CAD undergoing percutaneous coronary intervention (PCI)
have a high-risk for adverse clinical outcomes.
Residual inflammatory risk (RIR) in patients with CAD after standardized treatment is the
main cause of adverse events such as recurrent myocardial infarction, stroke, and death,
which has gained much interest in recent years. Inflammation plays an important role in the
development of CAD. However, several randomized controlled clinical studies (RCT) of
anti-inflammatory treatments ended in failure previously. Since 2017, the success of three
large-scale RCTs (CANTOS, COLCOT and LoDoCo2) points to targeting the NLRP3 - IL-1 β- IL-6
pathway for anti-inflammatory treatment of CAD. The inhibition of this pathway eventually
leads to the decrease of high-sensitivity C-reactive protein (hsCRP), consistent with an
anti-inflammatory effect. Therefore, the change of hsCRP may serve as a biomarker to screen
anti-inflammatory drugs in this pathway.
Targeting the NLRP3 - IL-1 β- IL-6 pathway with monoclonal antibodies is limited by high
prices of the biological agents. Thus, researchers focused on the upstream molecule NLRP3.
Currently, NLRP3 inhibitors that are clinically available include colchicine , tranilast and
oridonin. Although several studies have indicated the effective effects of colchicine in CAD,
the other two NLRP3 inhibitors lack sufficient data on anti-inflammatory treatment of CAD.
Therefore, we intend to use NLRP3 inhibitors (colchicine, tranilast and oridonin) to treat
patients after PCI for 4 weeks, compare the changes of hsCRP, and explore the effectiveness
and safety of these different drugs, and screen the optimal anti-inflammatory drugs for
coronary heart disease.