An analysis of a randomised trial published by a team of international researchers has investigated whether interleukin-1β (IL-1β) inhibition can reduce incident total hip or knee replacement (THR/TKR) for those with osteoarthritis. The trial was conducted in 39 countries and involved 10,061 participants who were randomly allocated to receive 50 mg, 150 mg or 300 mg canakinumab, or a placebo, subcutaneously every three months. During the median follow-up period of 3.7 years, hazard ratios (HR) [95% CI] for the 50, 150 and 300mg groups were 0.60 [0.38 to 0.95], 0.53 [0.33 to 0.84] and 0.60 [0.38 to 0.93] compared to the placebo, respectively. When individual canakinumab dose groups were combined, the incidence rate for THR/TKR was 0.31 events per 100 person-years, compared with 0.54 events per 100 person-years for the placebo group (HR 0.58 [0.42 to 0.80], P = 0.0001). The study was funded by Novartis Pharmaceuticals. These findings support the need for additional research into IL-1β inhibition as a potential treatment for large joint osteoarthritis. Details of the trial and analysis can be accessed here. 

Contributed by Isabella Singh, AMSS Associate.