Nephrology ·
Ziltivekimab misses cardiovascular and kidney outcomes in CKD; dialysis and conservative care preparation match in older adults
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The interleukin-6 inhibitor ziltivekimab lowered inflammation but did not reduce cardiovascular or kidney events in 6,376 patients with chronic kidney disease (CKD) and atherosclerosis in ZEUS. A U.K. trial found preparing older people for dialysis or for conservative care gave similar outcomes and ISCHEMIA-CKD EXTEND showed no long-term survival gain from invasive coronary care.
THE DETAILS
- Research Nov 7, 2026ZEUS randomly assigned patients with established atherosclerotic disease, chronic kidney disease and systemic inflammation to once-monthly subcutaneous ziltivekimab 15 mg or placebo. During a median follow-up of 33 months, the primary end point of cardiovascular death, nonfatal heart attack or nonfatal stroke occurred in 17.6% versus 17.7% (hazard ratio 0.99; 95% CI 0.88 to 1.11; P = .84), and a kidney composite in 20.2% versus 19.3%, Healio reported Nov. 7. Serious infections occurred in 20.4% and 17.9%. The results were published in the New England Journal of Medicine; Novo Nordisk previously announced them in July, Healio reported.Sources: Healio, New England Journal of Medicine
- Research Nov 4, 2026The U.K. trial, published Nov. 4 in The Lancet, recruited 445 older participants from 31 kidney centers and found that neither preparing for dialysis nor preparing for responsive conservative management resulted in better outcomes when length and quality of life were considered together, according to the University of Bristol. Over a mean follow-up of 4.5 years, 28% of those preparing for dialysis started it, and participants in both groups were more likely to die from other causes than to require dialysis. Dr. Fergus Caskey, a consultant nephrologist who led the study, said "Neither should be the default."
- Research Nov 7, 2026In extended follow-up of the randomized ISCHEMIA-CKD trial of patients with stable coronary disease and advanced chronic kidney disease, over a median of 8 years of follow-up, cumulative all-cause mortality was 57.4% with an initial invasive strategy and 56.8% with conservative management (adjusted hazard ratio 1.05; 95% CI 0.87 to 1.28), according to the Circulation abstract published Nov. 7. The authors concluded there was no significant long-term benefit of an initial invasive strategy.Source: Circulation
- Research Nov 7, 2026In the Brazilian trial of 9,476 adults with type 2 diabetes treated to a systolic target below 120 mm Hg or below 140 mm Hg, kidney events occurred in 5.7% of the intensive group and 3.7% of the standard group, according to the American Heart Association (AHA). These were mainly declines in kidney function, and end-stage renal disease was similar between groups. Major cardiovascular events were 6.0% versus 6.7%, a difference that was not statistically significant. The trial was presented Nov. 7 at the AHA Scientific Sessions.Source: American Heart Association
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