Anti-inflammatory strategies for atherosclerotic artery disease

Introduction: Atherosclerosis is the most frequent cause of coronary artery disease (CAD) and inflammation is a key driver of its pathogenesis. Targeting inflammation represents a novel therapeutic option beyond management of conventional cardiovascular risk factors. Recent efforts in cardiovascular research were aimed at investigating the efficacy and safety of existing and novel anti-inflammatory drugs. Areas covered: The multimodal activation of the immune response enables several approaches to mitigate the inflammatory burden of atherosclerosis, which include general cardiovascular preventive measures from healthy lifestyle behaviors to medications with ancillary anti-inflammatory effects, such as lipid-lowering drugs. Clinical development of several specific anti-inflammatory drugs has been halted due to lack of proven efficacy in humans, while a number of trials are ongoing to test drugs targeting the NLRP3-IL1-IL6-hsCRP pathway, including drugs that are already in use for immune disorders (i.e. colchicine). Expert opinion: The main challenge associated with specific anti-inflammatory drugs is the risk of immunological suppression. Due to positive results in recent randomized trials and a favorable safety profile, colchicine is expected to gain more popularity in the near future as an anti-inflammatory agent for cardiovascular prevention.