Individualized immunosuppression in virus-negative inflammatory cardiomyopathy

This commentary refers to ‘Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy: 20-year follow-up of the TIMIC trial’, by C. Chimenti et al., https://doi.org/10.1093/eurheartj/ehac348 and the discussion piece ‘Immunosuppressive therapy of myocarditis and inflammatory cardiomyopathy in the light of new data’, by K. Ozieranski et al., https://doi.org/10.1093/eurheartj/ehac500. We appreciate the authors’ comments on our study recently published in the European Heart Journal1 entitled: Immunosuppressive therapy in virus-negative inflammatory cardiomyopathy: 20-year follow-up of the tailored immunosuppression in virus-negative inflammatory cardiomyopathy (TIMIC) trial, emphasizing the potential therapeutic impact of inexpensive and usually safe drugs when specifically applied after a morpho-molecular characterization of myocardial tissue showing active virus-negative myocarditis. The authors claim for a multicentre, randomized, double blind, placebo-controlled study (Improve Myocarditis Clinical Trials. gov: NTC04654988 and EudraCT; 2020–003877-23) to confirm our results obtained in both short and long-term follow-up. We applaud this initiative although confirmation of our data has been already reported by many single-centre studies.2,3