Anakinra reduced CRP levels by 61% at 72 hours compared to a 6% reduction with placebo in patients with acute decompensated heart failure (P=0.004).
RCT (n=30)
Double-blind
1:1
Does anakinra reduce systemic inflammation (CRP levels) in patients with acute decompensated heart failure with reduced ejection fraction?
Interleukin-1 blockade with anakinra significantly reduces the acute systemic inflammatory response in patients with acute decompensated heart failure.
Absolute Event Rate: 61% vs 6%
p-value: p=0.004
BACKGROUND: Heart failure is an inflammatory disease. Patients with acute decompensated heart failure (ADHF) exhibit significant inflammatory activity on admission. We hypothesized that Interleukin-1 blockade, with anakinra (Kineret, Swedish Orphan Biovitrum), would quench the acute inflammatory response in patients with ADHF. METHODS: We randomized 30 patients with ADHF, reduced left ventricular ejection fraction (<40%), and elevated C reactive protein (CRP) levels (≥5 mg/L) to either anakinra 100 mg twice daily for 3 days followed by once daily for 11 days or matching placebo, in a 1:1 double blinded fashion. We measured daily CRP plasma levels using a high-sensitivity assay during hospitalization and then again at 14 days and evaluated the area-under-the-curve and interval changes (delta). RESULTS: Treatment with anakinra was well tolerated. At 72 hours, anakinra reduced CRP by 61% versus baseline, compared with a 6% reduction among patients receiving placebo (P = 0.004 anakinra vs. placebo). CONCLUSIONS: Interleukin-1 blockade with anakinra reduces the systemic inflammatory response in patients with ADHF. Further studies are warranted to determine whether this anti-inflammatory effect translates into improved clinical outcomes.
Tassell et al. (Tue,) conducted a rct in Acute Decompensated Heart Failure (n=30). Anakinra vs. Placebo was evaluated on Interval changes in CRP plasma levels at 72 hours versus baseline (p=0.004). Anakinra reduced CRP levels by 61% at 72 hours compared to a 6% reduction with placebo in patients with acute decompensated heart failure (P=0.004).