Anti-inflammatory agents in peripheral arterial disease

Inflammation is pivotally involved in coronary and peripheral atherosclerotic disease. This established concept is based on both experimental animal models of vascular inflammation and Mendelian randomization studies demonstrating a causal relationship between pro-inflammatory cytokines (e.g. interleukin-6) and cardiovascular disease risk. More recently, the reduction of cardiovascular events by use of an interleukin-1β inhibitor (canakinumab) has revived interest in the use of anti-inflammatory agents for the treatment of atherosclerotic disease, including peripheral arterial disease. In this mini review article we provide an update on the pleiotropic anti-inflammatory properties of approved drugs for use in cardiovascular disease (e.g. antiplatelets, statins, PCSK9 inhibitors) and discuss the role of targeted or untargeted anti-inflammatory atheroprotection in peripheral arterial disease by agents such as colchicine, methotrexate, anti-TNF-α agents and monoclonal antibodies against interleukin-signaling.