ClinicalTrials.gg
Not yet recruitingNCT07371689ANAPEMUpdated Jan 28, 2026

ANAKINRA IN THE TREATMENT OF PEDIATRIC ACUTE MYOCARDITIS

A Phase 3 interventional study of Anakinra, KINERET® in PEDIATRIC ACUTE MYOCARDITIS, sponsored by Assistance Publique - Hôpitaux de Paris. Not yet recruiting at 1 site in France. Open to participants aged 3 Months to 18 Years. Per ClinicalTrials.gov, last updated 2026-01-28.

Sponsored by Assistance Publique - Hôpitaux de Paris · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
110
Allocation
Randomized
Ages
3 Months to 18 Years
Sex
All
01

Study summary

Double blind RCT aiming to compare the efficacy of Anakinra vs placebo, on top of the standard of care, on restoration of myocardial function at 3 days following treatment initiation, in children admitted for acute myocarditis in intensive care units.

Read the detailed description

Activation of the inflammasome is increasingly recognized in the pathogenesis of acute myocarditis. We hypothesize that by blocking inflammasome using anakinra, we interfere with the key mechanism driving myocardial inflammation and fibrosis, allowing for restauration of myocardial function compared to standard of care alone. Children from ≥ 3 months to \< 18 years of age hospitalized in the Intensive Care Unit for acute myocarditis defined as a reduced left ventricle ejection fraction below 50% and troponin T rise (>1.5x normal range) will be randomized to either receive SC Anakinra or Placebo in addition to standard of care treatment. Primary endpoint: Proportion of children with recovered left ventricle ejection fraction (LVEF ≥ 50%) measured by echocardiography at 3 days after treatment initiation.

Secondary endpoints:

  1. Proportion of children with recovered left ventricle ejection fraction (LVEF

    ≥ 50%) measured by echocardiography at 7 and 28 days after treatment initiation. Patients who die or undergo heart transplant within the first 7 and 28 days after treatment initiation respectively will be considered as a failure (i.e, LVEF \< 50%). Patients who still require ECMO at 7 and 28 days after treatment initiation respectively will also be considered as failure (i.e., LVEF \< 50%).

  2. Time to recovery of normal left ventricular ejection fraction (LVEF ≥ 50%) within the first 3 days after treatment initiation
  3. Proportion of children requiring ECMO within the first 3 days after treatment initiation
  4. Proportion of children who undergo heart transplant within 6 months after treatment initiation
  5. Time to all-cause death within 6 months after treatment initiation
  6. Time to cardiovascular-related death within 6 months after treatment initiation
  7. Proportion of children with drug-related side effects (hypersensitivity, neutropenia, drug-related liver enzymes elevation…)
  8. a- NT proBNP at inclusion and at 24 hours, 48 hours, 72 hours following treatment initiation - Troponin T at inclusion and at 24 hours, 48 hours, 72 hours following treatment initiation - Proportion of children with ventricular tachycardia assessed by EKG at inclusion and at 24 hours, 48 hours, 72 hours following treatment initiation - b - NT proBNP at 7 days following treatment initiation - Troponin T at 7 days following treatment initiation - Proportion of children with ventricular tachycardia assessed by EKG at 7 days following treatment initiation - Proportion of children with fibrosis on cardiac MRI according to modified Lake Louise criteria at 6 months following treatment initiation - Proportion of children with dilated cardiomyopathy on cardiac echocardiography (Left ventricular end diastolic diameter ˃ 2 SD with altered systolic function \<50%) at 3 and 6 months following treatment initiation - Proportion of children with ventricular arrhythmia at 6 months following treatment initiation.
02

Conditions studied

  • PEDIATRIC ACUTE MYOCARDITIS

Keywords

  • Myocarditis
  • Anakinra
  • Anti-IL1
  • Inflammation
  • Pediatric
03

In context

Myocarditis

174 studies on the registry are indexed under Myocarditis; 75 are open to participants now.

This study's planned enrollment of 110 is above the median of 80 across 53 interventional studies indexed under Myocarditis.

Browse Myocarditis studies →

Lead sponsor

Assistance Publique - Hôpitaux de Paris is the lead sponsor of 3,592 studies on the registry; 1,033 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
3 Months to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Children from ≥ 3 months to \< 18 years of age
  • Hospitalized in the Intensive Care Unit (ICU) for acute myocarditis defined as : - a reduced left ventricle below 50% and - troponin T rise (>1.5x normal range), Signed by legal representative and patient according to the legislation.

Exclusion criteria

Exclusion Criteria:

  • Children weighing less than 5 Kgs
  • Known anterior cardiomyopathy or operated cardiopathy
  • Neutropenia (\< 1,5 × 10\^9 /L).
  • Known to Anakinra or any of its (citric acid anhydrous, sodium chloride, disodium EDTA dihydrate, polysorbate 80, E. coli derived proteins)
  • Administration of a in the 4 weeks prior to inclusion
  • infection, defined as positive HBsAg and/or detectable HBV DNA (PCR). Patients with increased risk of Tuberculosis (TB) infection
  • Recent tuberculosis infection or with active TB

    • Close contact with a patient with TB
    • Patients recently arrived less than 3 months from a country with high prevalence of TB
    • A chest radiograph suggestive of TB
  • Patients with overt concomitant bacterial infection
  • Patients previously treated with another biotherapy
  • Patients with any type of immunodeficiency or cancer
  • Anti TNF-α within the past 14 days
  • or history of malignancy or any comorbidity limiting survival or conditions predicting inability to complete the study Ongoing or recent use of any other medication Known inhibitors/inducers of cytochrome P450
  • Pregnancy or breastfeeding
  • No affiliation to the Social Security
  • Current enrollment in another clinical trial
  • Inability of the legal representative (and the patient, when applicable) to understand the national language (French)
Terms in these criteria, in plain language(7)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

LVEF (left ventricular ejection fraction)

The share of blood the heart’s main pumping chamber (the left ventricle) pushes out with each beat, measured by an echocardiogram (heart ultrasound) or a MUGA scan. About 50–70% is normal.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Live vaccines

Vaccines made with a weakened form of the germ, such as measles–mumps–rubella (MMR), chickenpox and yellow fever. They can be risky when the immune system is weakened. Flu injections are not live; the nasal flu spray is.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
110 participants (estimated)

Study arms

  • Experimental
    Anakinra

    Anakinra, KINERET, solution for injection in pre-filled syringe. Posology for clinical trial: 4 mg/Kg (maximum 100 mg) once daily subcutaneously for 7 days.

    Drug: Anakinra, KINERET®

  • Placebo comparator
    Placebo

    Placebo of Anakinra, solution of NaCl 0.9% Posology for clinical trial: 4 mg/Kg (maximum 100 mg) once daily subcutaneously for 7 days.

    Drug: Anakinra, KINERET®

Interventions

  • Patients will be randomized to receive Anakinra 4mg/Kg (maximum 100 mg) subcutaneously once a day for 7 days

06

What researchers measure

Primary outcomes

  1. Proportion of children with recovered left ventricle ejection fraction ≥ 50% measured by echocardiography at 3 days after treatment initiation.

    Main objective: To compare the efficacy of Anakinra vs placebo, on top of the standard of care, on restoration of myocardial function at 3 days following treatment initiation, in children admitted for acute myocarditis in intensive care units. Primary endpoint: Proportion of children with recovered left ventricle ejection fraction (LVEF ≥ 50%) measured by echocardiography at 3 days after treatment initiation. Patients who die within the first 3 days after treatment initiation or patients who still require ECMO at 3 days after treatment initiation will be considered as a failure.

    Time frame: 3 days

Secondary outcomes

  1. Proportion of children with recovered left ventricle ejection fraction ≥ 50% measured by echocardiography at 7 and 28 days after treatment initiation. Patients who die or undergo heart transplant within the first 7 and 28 days after treatment initiation

    Time frame: 7 and 28 days

  2. Time to recovery of normal left ventricular ejection fraction (LVEF ≥ 50%) within the first 3 days after treatment initiation

    Time frame: 3 days

  3. Proportion of children requiring ECMO within the first 3 days after treatment initiation

    Time frame: 3 days

  4. Proportion of children who undergo heart transplant within 6 months after treatment initiation

    Time frame: 6 months

  5. Time to all-cause death within 6 months after treatment initiation

    Time frame: 6 months

  6. Time to cardiovascular-related death within 6 months after treatment initiation

    Time frame: 6 months

  7. Proportion of children with drug-related side effects (hypersensitivity, neutropenia, drug-related liver enzymes elevation…)

    Time frame: 6 months

  8. following treatment initiation-TroponinT at inclusion and at24 hours,48 hours,72 hours following treatment initiation-Proportion of children with ventricular tachycardia assessed by EKG at inclusion and at 24hours,48hours,72hours following treatment init

    Time frame: 24,48,72 hours

  9. NTproBNP at7days, Troponin T at7days,Proportion of children with ventricular tachycardia assessed by EKG at7days, Proportion of children with fibros on cardiac MRI at6months,Proportion of children with dilated cardiomyopathy,with ventricular arrhythmia

    Time frame: 7 days - 3 and 6 months

07

Study locations

1 site
  • Bicêtre Hospital - APHP, Pediatric intensive care unit
    Le Kremlin-Bicêtre, France 94275, France
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jan 28, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07371689
Responsible party
Sponsor
First posted
Jan 28, 2026
Start date
Feb 2026 (estimated)
Primary completion
Dec 2029 (estimated)
Completion
Dec 2029 (estimated)
Last update
Jan 28, 2026

Study contacts

Ramy CHARBEL, Study Principal Investigator
Contact
ramy.charbel@aphp.fr
01 45 21 32 05

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Oct 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Interleukin 1 Receptor Antagonist Protein

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