Clinical outcomes of anti-inflammatory therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway in coronary artery disease patients: a systemic review and meta-analysis of 37,056 individuals from 32 randomized trials.

IF 5.4 3区医学 Q2 CELL BIOLOGY

Inflammation Research Pub Date : 2025-06-30 DOI:10.1007/s00011-025-02058-9

Yannan Pan, Fangfang Fan, Jie Jiang, Yan Zhang

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Abstract

Background: Treatment effects of anti-inflammatory therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway in coronary artery disease (CAD) had conflicting results. The study aims to evaluate efficacy and safety outcomes of treatments inhibiting this pathway.

Methods: Cochrane Library, Embase, Pubmed, and ClinicalTrials.gov were searched for randomized controlled trials evaluating therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway in CAD patients. Relative risks (RR) with 95% confidence intervals (CI) were calculated.

Results: 32 studies and 37,056 individuals were included. Anti-inflammatory therapies inhibiting the pathway reduced the risks of myocardial infarction (MI) (RR 0.85, 95% CI 0.78-0.93) and coronary revascularization (RR 0.80, 95% CI 0.74-0.86), with no benefits in major adverse cardiovascular events (MACE), heart failure (HF), stroke, cardiovascular or all-cause mortality. Colchicine reduced the risks of MACE, MI, and coronary revascularization. IL-1 inhibitors reduced the risks of coronary revascularization, with potential benefits in MI and HF. Increased risks of infections, gastrointestinal adverse effects, and injection site reactions were found. Meta-regression analysis demonstrated that post-treatment hsCRP/CRP was correlated with MACE (p < 0.001) and MI (p = 0.048) and post-treatment IL-6 was associated with MI (p = 0.033).

Conclusion: Anti-inflammatory therapies inhibiting the NLRP3/IL-1β/IL-6/CRP pathway had satisfying safety profiles and were beneficial in preventing MI and coronary revascularization in CAD patients despite no benefits in stroke, cardiovascular, or all-cause mortality.

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抗炎疗法抑制冠心病患者NLRP3/IL-1β/IL-6/CRP通路的临床结果：一项来自32项随机试验的37,056人的系统评价和荟萃分析

背景：抗炎疗法抑制NLRP3/IL-1β/IL-6/CRP通路在冠心病（CAD）中的治疗效果有矛盾的结果。该研究旨在评估抑制该途径的治疗的疗效和安全性。方法：检索Cochrane Library、Embase、Pubmed和ClinicalTrials.gov中评估CAD患者NLRP3/IL-1β/IL-6/CRP通路抑制疗法的随机对照试验。计算相对危险度（RR）和95%可信区间（CI）。结果：纳入32项研究和37,056名个体。抑制该通路的抗炎治疗降低了心肌梗死（MI）（RR 0.85, 95% CI 0.78-0.93）和冠状动脉血运重建术（RR 0.80, 95% CI 0.74-0.86）的风险，但对主要不良心血管事件（MACE）、心力衰竭（HF）、中风、心血管或全因死亡没有益处。秋水仙碱降低了MACE、心肌梗死和冠状动脉血运重建的风险。IL-1抑制剂降低了冠状动脉血运重建的风险，对心肌梗死和心衰有潜在的益处。发现感染、胃肠道不良反应和注射部位反应的风险增加。荟萃回归分析显示，治疗后hsCRP/CRP与MACE相关(p)。结论：抗炎疗法抑制NLRP3/IL-1β/IL-6/CRP通路具有令人满意的安全性，有助于预防冠心病患者心肌梗死和冠状动脉血运重建，尽管对卒中、心血管或全因死亡率没有益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Inflammation Research 医学-免疫学

CiteScore

9.90

自引率

1.50%

发文量

134

审稿时长

3-8 weeks

期刊介绍： Inflammation Research (IR) publishes peer-reviewed papers on all aspects of inflammation and related fields including histopathology, immunological mechanisms, gene expression, mediators, experimental models, clinical investigations and the effect of drugs. Related fields are broadly defined and include for instance, allergy and asthma, shock, pain, joint damage, skin disease as well as clinical trials of relevant drugs.