Pilot Study of the Safety and Efficacy of Anakinra (Recombinant Human Interleukin-1 Receptor Antagonist) in Heart Failure

Inclusion Criteria:

- Confirmed diagnosis of heart failure

- Recent echocardiogram documenting left ventricular ejection fraction <40%

- High sensitivity C-reactive protein >2 mg/L.

Exclusion Criteria:

- Recent changes (previous 3 months) in HF maintenance medications (beta-blockers,
angiotensin converting enzyme [ACE] inhibitors, aldosterone antagonists, vasodilators,
cardiac glycosides, diuretics)

- Hospitalization for worsening HF or acute decompensated HF within the previous 12
months

- Anticipated need for cardiac resynchronization therapy (CRT) or automated-implantable
cardioverter defibrillator (AICD)

- Angina or electrocardiograph (ECG) changes that limit maximum exertion during
cardiopulmonary exercise testing or baseline ECG changes that limit the ability to
detect ischemia (i.e. left bundle-branch block).

- Recent (<14 days) use of anti-inflammatory drugs (not including NSAIDs), chronic
inflammatory disorder (including but not limited to rheumatoid arthritis, systemic
lupus erythematosus), malignancy, active infection, or any comorbidity limiting
survival or ability to complete the study

- Severe kidney dysfunction (eGFR <30 mL/min)

- Coagulopathy (INR >1.5), thrombocytopenia (<50,000/mm3), or leukopenia (absolute
neutrophil count <1,500/mm3)

- Pregnancy (female patients will be required to take a urine pregnancy test)

- Latex or rubber allergy

- Inability to give informed consent