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<DIV>ATLANTA (EGMN) – Anakinra, an interleukin-1 blocker prescribed for rheumatoid arthritis, may also have a future as a treatment for acute myocardial infarction. </DIV>
<DIV>In a small but provocative pilot study, 2 weeks of daily subcutaneous 100-mg injections of anakinra in patients with ST-elevation MI had a favorable effect on ventricular remodeling. Thus, interleukin-1 blockade may offer a novel therapeutic strategy for the prevention of heart failure after MI, Dr. Roshanak Robati said at the annual meeting of the American College of Cardiology. </DIV>
<DIV>The primary end point in the randomized, double-blind, 10-patient study was change in left ventricular end-systolic volume index between the baseline assessment 24-96 hours after hospital admission and repeat measurement 10-14 weeks later. There was a median 3.2-mL/m<SUP>2</SUP> decrease as assessed by cardiac magnetic resonance in the anakinra recipients and a 2.0-mL/m<SUP>2</SUP> increase with placebo, for a highly significant 5.2-mL/m<SUP>2</SUP> difference between the two study arms. </DIV>
<DIV>The same pattern was true for the change in left ventricular end-diastolic volume index, with a median 7.6-mL/m<SUP>2</SUP> difference between the anakinra and placebo groups, according to Dr. Robati, an internal medicine resident at Virginia Commonwealth University, Richmond. </DIV>
<DIV>The change in C-reactive protein levels during the first 72 hours following admission correlated in linear fashion with the change in left ventricular end-systolic volume index over the course of 10-14 weeks, she added. </DIV>
<DIV>This pilot study was funded by university research money with no industry support. In an interview, Dr. Robati said the next logical step would be a much larger trial, but Biovitrum, which markets anakinra, is not interested in pursuing a potential cardiovascular application for the biologic agent. The principal investigator in the pilot study, Dr. Antonio Abbate, also of the university, is pursuing alternative funding, including an application for a U.S. National Institutes of Health research grant.</DIV>
<DIV>Dr. Robati indicated she has no relevant financial interests. </DIV>
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<DIV>Copyright (c) 2009 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.</DIV>
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<DIV>亚特兰大(EGMN)——白介素-1(IL-1)受体拮抗剂阿那白滞素(Anakinra)为风湿性关节炎的处方药，今后可能还会用于急性心肌梗死(MI)的治疗。</DIV>
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<DIV>在一项小规模但有激发性的初步研究中，ST段抬高的MI患者应用阿那白滞素治疗(皮下注射给药，100 mg/d，持续2周)对心室重构的效果较优。因此，IL-1受体拮抗剂可能为预防MI后心力衰竭提供了一种新型治疗策略，Roshanak Robati博士在美国心脏病学会年会上说。</DIV>
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<DIV>在这项随机、双盲、包括10例患者的研究中，主要研究终点为住院后24~96 h的基线评估与10~14周后再次测定之间左室收缩末期容积指数的变化。采用心脏磁共振检查评价发现，阿那白滞素治疗者中位减少值为3.2 ml/m<SUP>2</SUP>，而安慰剂对照组中位增加值为2.0 ml/m<SUP>2</SUP>，两个研究组之间相差5.2 ml/m<SUP>2</SUP>，具有极显著的统计学差异。</DIV>
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<DIV>里士满弗吉尼亚联邦大学内科医学住院医师Robati博士称，在左室舒张末期容积指数上亦观察到相同的变化模式，阿那白滞素治疗组与安慰剂对照组之间的中位差值为7.6 ml/m<SUP>2</SUP> 。</DIV>
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<DIV>住院后最初72 h内的C反应蛋白水平变化与10~14周内左室收缩末期容积指标的变化呈线性相关，她补充道。</DIV>
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<DIV>这项初步研究得到大学研究基金的资助，无企业资助。Robati博士在一次访问中说，下一个合乎逻辑的步骤应为进行一项较大规模的试验，但阿那白滞素销售商Biovitrum公司在探讨该生物制剂潜在的心血管应用方面并无兴趣。该初步研究的首席研究员、同任职于该大学的Antonio Abbate博士目前在寻找他方资助，其中包括申请美国国立卫生研究院研究基金。</DIV>
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<DIV>Robati博士表示其本人无相关的经济利益。</DIV></DIV> |
