Ziltivekimab lowered inflammation markers, but ZEUS found no cardiovascular-event benefit

At AHA 2026, the phase 3 ZEUS trial reported that monthly ziltivekimab substantially lowered inflammation markers in people with atherosclerotic cardiovascular disease, chronic kidney disease, and elevated inflammation—but did not reduce major cardiovascular events versus placebo.

After a median 33 months, the primary outcome—cardiovascular death, nonfatal heart attack, or nonfatal stroke—occurred in 17.6% of participants taking ziltivekimab and 17.7% taking placebo (hazard ratio 0.99; 95% CI 0.88–1.11; P=0.84).

Compared with placebo, ziltivekimab lowered high-sensitivity C-reactive protein by about 64% and interleukin-6 by about 76%. The biomarker improvements did not translate into fewer cardiovascular events or deaths.

The findings challenge the idea that suppressing this particular inflammation pathway will necessarily prevent cardiovascular events in this patient group. Researchers say inflammation remains an important research target, while noting that trial-population and pathway differences may help explain the neutral result.