Anakinra improves exercise peak aerobic capacity in patients with recently decompensated systolic heart failure

Objective: To evaluate the effects of anakinra on aerobic exercise capacity in patients with recently decompensated systolic HF and systemic inflammation. Methods: We randomly assigned 60 patients with reduced leftventricular ejection fraction (<50%) and elevated C-reactive protein (CRP) levels (...

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Published inVascular pharmacology Vol. 103-105; p. 47
Main Authors Van Tassell, B.W., Viscusi, M.M., Del Buono, M.G., Canada, J., Carbone, S., Trankle, C., Buckley, L., Lesnefsky, E., Arena, R., Abbate, A.
Format Journal Article
LanguageEnglish
Published Philadelphia Elsevier Inc 01.04.2018
Elsevier Science Ltd
Subjects
Aerobic capacity
C-reactive protein
Clinical trials
Drug therapy
Exercise
Heart diseases
Heart failure
Interleukin 1 receptor antagonist
Oxygen consumption
Patients
Proteins
Vanadium oxides
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Summary:Objective: To evaluate the effects of anakinra on aerobic exercise capacity in patients with recently decompensated systolic HF and systemic inflammation. Methods: We randomly assigned 60 patients with reduced leftventricular ejection fraction (<50%) and elevated C-reactive protein (CRP) levels (>2 mg/L), within 14 days of hospital discharge, to daily subcutaneous injections with anakinra 100 mg for 2 weeks, 12 weeks, or placebo in the REcently Decompensated Heart failure Anakinra Response Trial (REDHART) clinical trial (www.dinicaltrials.gpv identifier: NCT01936909). Patients underwent measurement of peak oxygen consumption (VO2 [mL‧kg-1 ‧ min-1) and ventilatory efficiency (the VE/VCO2 slope) at 2,4.12, and 24 weeks. Results: Treatment with anakinra did not affect peak VO2 or VE/VCO2 slope at 2 weeks. At 12 weeks, anakinra treatment for 12 weeks reduced CRP levels by > 60% (P < 0.01) and improved peak VO2 from 14.5 [10.5-16.6] to 16.1 [132-18.6] mL‧kg-1‧min-1 (P = 0.008), whereas treatment with anakinra for 2 weeks or placebo had no significant effect on CRP levels or peak V02. The incidence of death or readmission for HF at 24 weeks was 6%, 31%, and 30%, in the anakinra 12-week, anakinra 2-week and placebo groups, respectively. Conclusion: Treatment with anakinra for 12 weeks improved aerobic capacity in patients with recently decompensated systolic HF, while treatment for 2 weeks did not.
ISSN:1537-1891
1879-3649
DOI:10.1016/j.vph.2017.12.002