The CANTOS trial results supporting the inflammation hypothesis and presented at ESC 2017 sure roused quite a bit of excitement amongst clinicians and researchers. I was reading a commentary on the CANTOS trial and it referred to another ongoing trial called the Cardiovascular Inflammation Reduction Trial (CIRT), in which patients with type-2 diabetes or metabolic syndrome are being given low-dose methotrexate to investigate whether this anti-inflammatory approach will reduce 3-point MACE (cardiovascular death, stroke, myocardial infarction). Both CIRT and CANTOS are lead by Dr. Paul Ridker. Looks like CIRT is scheduled to read out in 2019. Here are a few articles on the subject. Definitely something to keep on the radar. Of note, low-dose methotrexate is a cheap, generic therapy given orally as a once-weekly agent. Recall, in CANTOS Canakinumab reduced pooled 3-point MACE by 12-15% (depending upon dose); however, upon looking individually at cardiovascular death, stroke, or myocardial infarction, only reductions in myocardial infarction achieved statistical significance. 

Closing the Loop on Inflammation and Atherothrombosis: Why Perform the Cirt and Cantos Trials?

Rationale and Design of the Cardiovascular Inflammation Reduction Trial (CIRT): A Test of the Inflammatory Hypothesis of Atherothrombosis

Systematic Review and Meta-analysis of Methotrexate Use and Risk of Cardiovascular Disease