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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 …