Anakinra 100 mg once or twice daily versus placebo will be evaluated for its effect on the area under the curve for C-reactive protein over 14 days in 99 patients with STEMI.
RCT (n=99)
Double-blind
1:1:1
Yes
Does anakinra reduce the area under the curve for C-reactive protein in patients with acute STEMI?
This paper describes the rationale and design of the VCU-ART3 trial, which evaluates the safety and efficacy of IL-1 blockade with anakinra during the acute phase of STEMI to reduce inflammation and adverse cardiac remodeling.
There is clear association between the intensity of the acute inflammatory response during acute myocardial infarction (AMI) and adverse prognosis after AMI. Interleukin-1 (IL-1) is a pro-inflammatory cytokine released during AMI and involved in adverse remodeling and heart failure (HF). We describe a study to evaluate the safety and efficacy of IL-1 blockade using an IL-1 receptor antagonist (anakinra) during the acute phase of ST-segment elevation myocardial infarction (STEMI). The Virginia Commonwealth University-Anakinra Remodeling Trial-3 (VCU-ART3; http://www.ClinicalTrials.gov NCT01950299) is a phase 2, multicenter, double-blinded, randomized, placebo-controlled clinical trial comparing anakinra 100 mg once or twice daily vs matching placebo (1:1:1) for 14 days in 99 patients with STEMI. Patients who present to the hospital with STEMI within 12 hours of symptom onset will be eligible for enrollment. Patients will be excluded for a history of HF (functional class III-IV), severe valvular disease, severe kidney disease (stage 4-5), active infection, recent use of immunosuppressive drugs, active malignancy, or chronic autoimmune/auto-inflammatory diseases. We will measure the difference in the area under the curve for C-reactive protein between admission and day 14, separately comparing each of the anakinra groups with the placebo group. The P value will be considered significant if <0.025 to adjust for multiple comparisons. Patients will also be followed for up to 12 months from enrollment to evaluate cardiac remodeling (echocardiography), cardiac function (echocardiography), and major adverse cardiovascular outcomes (cardiovascular death, MI, revascularization, and new onset of HF).
Tassell et al. (Mon,) conducted a rct in ST-segment elevation myocardial infarction (STEMI) (n=99). anakinra vs. matching placebo was evaluated on difference in the area under the curve for C-reactive protein between admission and day 14. Anakinra 100 mg once or twice daily versus placebo will be evaluated for its effect on the area under the curve for C-reactive protein over 14 days in 99 patients with STEMI.