Does Interleukin-1β Inhibition Change the Natural History of Osteoarthritis?

Patients with osteoarthritis (OA) usually receive palliative care with analgesics, nonsteroidal anti-inflammatory drugs, and physical therapy; if OA symptoms progress, surgery becomes an option. Some evidence shows that low-grade inflammation plays a role in development of OA, and many inflammatory mediators are detected in the joints of OA patients. In an exploratory analysis of the CANTOS trial, in which 10,000 patients with elevated C-reactive protein levels and prior myocardial infarction received canakinumab (Ilaris; a human monoclonal antibody targeting interleukin [IL]-1β) or placebo for 5 years, researchers evaluated whether total hip or total knee replacements differed in the two arms.

Median follow-up was 3.7 years. Rates for total…