CClinicalTrials.gg
TerminatedNCT03224585Updated Feb 23, 2021Results posted

Treatment of Acute Pericarditis With Anakinra

A Phase 2 interventional study of Anakinra and Placebo in Acute Pericarditis, sponsored by Virginia Commonwealth University. Terminated at 1 site in United States. Open to participants aged 12 Years and older. Per ClinicalTrials.gov, last updated 2021-02-23.

Sponsored by Virginia Commonwealth University · Phase 2, Interventional, and Treatment

Why this study was terminated
Study was terminated because dramatic benefits seen during the first 24 hours of drug administration combined with COVID restrictions on research activities suggested it was both unethical and unnecessary to complete the planned enrollment
Phase
Phase 2
Study type
Interventional
Enrollment
5
Allocation
Randomized
Ages
12 Years and older
Sex
All
01

Study summary

The goal of this study is to determine the safety and efficacy of anakinra for the treatment of acute pericarditis when initiated within 6 hours of diagnosis and continued for 3 or 7 days.

  1. to determine the efficacy of anakinra with respect to chest pain resolution
  2. to determine the safety of anakinra with respect to adverse drug events
Read the detailed description

Acute pericarditis is a clinical syndrome characterized by a profound inflammation of the membrane tissue that surrounds, supports and protects the heart. Acute pericarditis can be caused by a variety of infectious and non-infectious agents, but it most commonly either follows a viral infection of the upper respiratory tract or has no apparent cause.

Acute pericarditis occurs rather abruptly in previously healthy individuals, generally a child or young adult. Most cases of acute pericarditis resolve within a few days with non-steroidal anti-inflammatory drugs. However, patients experience severe chest pain and are at high risk for life-threatening complications involving the pericardium, such as pericardial tamponade. Acute pericarditis is diagnosed in 1 in 20 (5%) ED visits for chest pain.

Anakinra (Kineret) has been shown to treat and cure refractory and recurrent pericarditis. This study is aimed at determining whether anakinra is also effective as first line treatment in acute pericarditis.

02

Conditions studied

  • Acute Pericarditis

Browse trials for

Keywords

  • anakinra
  • Kineret
  • pericarditis
03

Who can participate

Ages eligible
12 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Age ≥12 years in presence of a parent able to provide consent or age >18 years
  • First or recurrent episode of acute pericarditis, defined as the presence of at least 2 of the following:
  • Chest pain (suggestive of pericarditis and not explained by another condition)
  • Pericardial friction rub on physical exam
  • ST-segment elevation and/or PR depression on ECG
  • New or worsening pericardial effusion
  • Pain of moderate-to-severe intensity (pain score ≥6 on a scale of 0-10 where 0 is no pain at all and 10 is the worst pain ever experienced) at time on enrollment
  • Ability to provide written informed consent if 18 years or older or to provide assent in presence of parental consent if 12-17 years of age

Exclusion criteria

Exclusion Criteria:

  • Pericarditis due to known bacterial or fungal infection
  • Pericarditis due to known malignancy
  • Pericarditis after cardiac surgery
  • Tamponade or need for pericardiocentesis for diagnostic/therapeutic purposes
  • Pregnancy or breastfeeding
  • Hypersensitivity to anakinra, latex or products derived from Escherichia coli
  • Chronic pain syndrome or chronic use of analgesic drugs
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
5 participants (actual)

Study arms

  • Experimental
    Anakinra

    100 mg subcutaneous injection

    Drug: Anakinra

  • Placebo comparator
    Placebo

    100 mg NaCl 0.9% subcutaneous injection

    Drug: Placebo

Interventions

  • DrugAnakinra

    Period 1 (Time 0-72 hours) - this will be an open-label phase during which all subjects meeting enrollment criteria will receive anakinra 100 mg subcutaneously injections daily for 3 days. Period 2 (Time 72 hours to 7 days) - anakinra 100 mg subcutaneous injections daily for 4 days

  • DrugPlacebo

    Period 1 (Time 0-72 hours) - this will be an open-label phase during which all subjects meeting enrollment criteria will receive anakinra 100 mg subcutaneously injections daily for 3 days. Period 2 (Time 72 hours to 7 days) - placebo 100 mg saline subcutaneous injections daily for 4 days

05

What researchers measure

Primary outcomes

  1. Pain Score

    Change from baseline in visual analog pain score from 0 to 10. For this visual analog pain scale, the patient is asked to rate their pain from 0 to 10. A score of 0 represents "no pain", a score of 5 represents "moderate pain", and 10 represents "worst pain".

    Time frame: Baseline to 6 hours

Secondary outcomes

  1. Pain Score

    Change from baseline in visual analog pain score from 0 to 10. For this visual analog pain scale, the patient is asked to rate their pain from 0 to 10. A score of 0 represents "no pain", a score of 5 represents "moderate pain", and 10 represents "worst pain".

    Time frame: Baseline to 24 hours

06

Results

Posted Feb 23, 2021

Participant flow

Participant flow — Overall Study
MilestoneAnakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)
Started23
Completed23
Not completed00

Outcome measures

PrimaryPain Score

Change from baseline in visual analog pain score from 0 to 10. For this visual analog pain scale, the patient is asked to rate their pain from 0 to 10. A score of 0 represents "no pain", a score of 5 represents "moderate pain", and 10 represents "worst pain".

Time frame:
Baseline to 6 hours
Reported as:
Median · units on a scale
Pain Score
units on a scaleAll Patients
Pain Score-3 (-3 to -2)
Statistical analysis
  • All Patients · Paired samples Wilcoxon test · p = 0.0121
SecondaryPain Score

Change from baseline in visual analog pain score from 0 to 10. For this visual analog pain scale, the patient is asked to rate their pain from 0 to 10. A score of 0 represents "no pain", a score of 5 represents "moderate pain", and 10 represents "worst pain".

Time frame:
Baseline to 24 hours
Reported as:
Median · units on a scale
Pain Score
units on a scaleAll Patients
Pain Score-4 (-4.25 to 4)
Statistical analysis
  • All Patients · Paired samples Wilcoxon test · p = 0.0025

Adverse events

Collected over 30 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Anakinra (3 Days) Then Anakinra (4 Days)0/2 (0%)0/2 (0%)1/2 (50%)
Anakinra (3 Days) Then Placebo (4 Days)0/3 (0%)3/3 (100%)1/3 (33.3%)
Most frequent serious events
Most frequent serious events
EventAnakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)
Thrombophlebitis - After completion of anakinraVascular disorders0/21/3
Coronary vasospasm - After completion of anakinraCardiac disorders0/21/3
Resistant pericarditis - After completion of anakinraCardiac disorders0/21/3
Most frequent other events
Most frequent other events
EventAnakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)
Injection site reactions - While taking anakinraSkin and subcutaneous tissue disorders1/21/3

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Anakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)Total
<=18 years000
Between 18 and 65 years235
>=65 years000
Age, Continuous
Age, Continuous(years)Anakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)Total
Mean42 ± 940 ± 1641 ± 12
Sex: Female, Male
Sex: Female, Male(Participants)Anakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)Total
Female101
Male134
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Anakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)Total
American Indian or Alaska Native000
Asian000
Native Hawaiian or Other Pacific Islander000
Black or African American112
White123
More than one race000
Unknown or Not Reported000
Region of Enrollment
Region of Enrollment(participants)Anakinra (3 Days) Then Anakinra (4 Days)Anakinra (3 Days) Then Placebo (4 Days)Total
United States235
07

Study locations

1 site
  • Virginia Commonwealth University
    Richmond, Virginia 23298, United States
08

References and documents

Publications

  • Wohlford GF, Buckley LF, Vecchie A, Kadariya D, Markley R, Trankle CR, Chiabrando JG, de Chazal HM, Van Tassell B, Abbate A. Acute Effects of Interleukin-1 Blockade Using Anakinra in Patients With Acute Pericarditis. J Cardiovasc Pharmacol. 2020 Jul;76(1):50-52. doi: 10.1097/FJC.0000000000000847. PubMed 32398478 ↗

Study documents

  • Informed consent form · Jun 8, 2017
  • Study protocol · Jun 8, 2017
  • Statistical analysis plan · Jun 8, 2017

Documents are hosted by the registry — open the source record to download them.

09

Registry details

Key details

Study ID
NCT03224585
Lead sponsor
Virginia Commonwealth University
Responsible party
Sponsor
First posted
Jul 21, 2017
Start date
May 11, 2018
Primary completion
Feb 1, 2020
Completion
Feb 1, 2020
Results posted
Feb 23, 2021
Last update
Feb 23, 2021

Study contacts

Antonio Abbate, MD, PhD
principal investigator · Virginia Commonwealth University

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is terminated, as verified in Feb 2021. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion