Although we are still awaiting the full publication, THIS ANNOUNCEMENT was made today that ziltivekimab, an IL-6 inhibitor, went the way of Hades in the ZEUS trial.  Unlike historic trials of other agents targeting inflammation (such as canakinumab and low-dose colchicine), this medication failed to reduce cardiovascular events in over 6,000 patients with cardiovascular disease, chronic kidney disease, and elevated inflammation as measured by hs-CRP. 

We figured it would take a Herculean effort to demonstrate efficacy in a patient population treated with other strong, proven background therapies.  And at this point, I can understand why many see this as a Titanic disappointment and are ready to stick a Poseidon-sized fork in the approach of targeting inflammation for cardiovascular disease prevention.  Inflammation, in the right context, is a good thing, and, somewhat unsurprisingly, increased infection rates have been quite the Achilles heel for these types of anti-inflammatory medications.  However, if your inflammation is due to Angry Adipose and the body resenting your chronic state of overnutrition, then your Fate becomes quite ominous unless we appropriately intervene.

And studies LIKE THIS suggest IL-6 is more closely related to cardiovascular disease and heart failure when compared to the less-specific hs-CRP.  But ultimately, this most recent underwhelming result from ZEUS speaks to the importance of getting to the ROOT CAUSE of inflammation rather than just crushing your favorite interleukin (and IL-6 is my favorite interleukin, as I discuss in Chapter 3 of THIS BOOK. I’m sure if you’re reading this you also “break the ice” at parties by asking people about their favorite cytokine).

So anyway, apparently there are a couple of other ziltivekimab trials still in process (named HERMES and ARTEMIS), although I’d be pretty surprised if either of those end up successfully reaching the summit of Mt. Olympus in achieving their endpoints.

Inflammation matters.  But getting to the nidus of the inflammation will ensure that you return safely to Ithaca rather than getting lost in an endless Odyssey of chasing inflammatory markers.