Heart failure & cardiomyopathiesCohort study
Time-dependent effects of interleukin-1 blockade by anakinra in myocarditis and inflammatory cardiomyopathy
- Cohort study
- consecutive patients
- time-updated Kaplan-Meier analysis
Authors' conclusion
Anakinra was associated with a marked reduction in MAE during active treatment, with re-emergence after discontinuation, supporting a potential role for sustained IL-1 blockade in selected high-risk patients.
Study context
- Population
- Patients with definite myocarditis or inflammatory cardiomyopathy diagnosed by CMR with or without endomyocardial biopsyfollow-up 51 ± 20 months
- Participants
- 42 patients
- Exposure
- Anakinra treatment phase vs pre-treatment and post-discontinuation phases
- Outcome
- Major adverse events:
- Cardiac death
- Heart transplantation
- Major ventricular arrhythmias
- Hospitalization for acute HF
- Recurrent myocarditis
Main finding
As reported in the abstract
MAE
- Events rare during active treatment; most deaths (7/8) and all major ventricular arrhythmias occurred outside the treatment phase
- During treatment vs Pre-treatment and post-discontinuation: P < 0.001
- time-updated Kaplan-Meier analysis
Observational data: associations, not effects.
Further findings
| Outcome | During treatment | Pre-treatment | Post-discontinuation | P value |
|---|---|---|---|---|
| Recurrent myocarditis | 1/42 events | 9/32 events | 3/37 events | P = 0.002 |
Cardiac-related hospitalizations
- Decreased during treatment and increased thereafter
Troponin, left ventricular ejection fraction (LVEF), CMR inflammatory abnormalities, arrhythmic burden
- Improvements paralleling major adverse events (MAE) changes; LVEF improved ≥5% in one-third
Original publication
Time-dependent effects of interleukin-1 blockade by anakinra in myocarditis and inflammatory cardiomyopathy. Eur J Heart Fail. Published 26 June 2026. doi:10.1093/ejhf/xuag194
Summarised from the published abstract; every number is checked against it