Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Wild brazilian mustard (Brassica juncea L.) seed oil methyl esters as biodiesel fuel

Wild mustard (Brassica juncea L.) oil is evaluated as a feedstock for biodiesel production. Biodiesel was obtained in 94 wt.% yield by a standard transesterification procedure with methanol and sodium methoxide catalyst. Wild mustard oil had a high content of erucic (13(Z)‐docosenoic; 45.7 wt.%) acid, with linoleic (9(Z),12(Z)‐octadecadienoic; 14.2 wt.%) and linolenic (9(Z),12(Z),15(Z)‐octadecatrienoic; 13.0 wt.%) acids comprising most of the remaining fatty acid profile. The cetane number, kinematic viscosity, and oxidative stability (Rancimat method) of the methyl esters was 61.1, 5.33 mm^2 s^−1 (40 °C) and 4.8 h (110 °C), respectively. The cloud, pour and cold filter plugging points were 4, −21 and −3 °C, respectively. Other properties such as acid value, lubricity, free and total glycerol content, iodine value, Gardner color, specific gravity, as well as sulfur and phosphorous contents were also determined and are discussed in light of biodiesel standards ASTM D6751 and EN 14214. Also reported are the properties and composition of wild mustard oil, along with identification of wild mustard collected in Brazil as Brassica juncea L. (2n = 36) as opposed to the currently accepted Sinapis arvensis L. (2n = 18) classification. In summary, wild mustard oil appears to be an acceptable feedstock for biodiesel production

Wild Brazilian Mustard (Brassica juncea L.) Seed Oil Methyl Esters as Biodiesel Fuel

Wild mustard (Brassica juncea L.) oil is evaluated as a feedstock for biodiesel production. Biodiesel was obtained in 94 wt.% yield by a standard transesterification procedure with methanol and sodium methoxide catalyst. Wild mustard oil had a high content of erucic (13(Z)‐docosenoic; 45.7 wt.%) acid, with linoleic (9(Z),12(Z)‐octadecadienoic; 14.2 wt.%) and linolenic (9(Z),12(Z),15(Z)‐octadecatrienoic; 13.0 wt.%) acids comprising most of the remaining fatty acid profile. The cetane number, kinematic viscosity, and oxidative stability (Rancimat method) of the methyl esters was 61.1, 5.33 mm^2 s^−1 (40 °C) and 4.8 h (110 °C), respectively. The cloud, pour and cold filter plugging points were 4, −21 and −3 °C, respectively. Other properties such as acid value, lubricity, free and total glycerol content, iodine value, Gardner color, specific gravity, as well as sulfur and phosphorous contents were also determined and are discussed in light of biodiesel standards ASTM D6751 and EN 14214. Also reported are the properties and composition of wild mustard oil, along with identification of wild mustard collected in Brazil as Brassica juncea L. (2n = 36) as opposed to the currently accepted Sinapis arvensis L. (2n = 18) classification. In summary, wild mustard oil appears to be an acceptable feedstock for biodiesel production

Antiinflammatory therapy with canakinumab for atherosclerotic disease

BACKGROUND: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P=0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P=0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P=0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P=0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P=0.31). CONCLUSIONS: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. Copyright © 2017 Massachusetts Medical Society