Recent trials of anti-tumour necrosis factor α treatment in patients with heart failure
| Trial | Design | Outcome | Published |
|---|---|---|---|
| NYHA, New York Heart Association classification of heart failure. | |||
| Deswal et al | Randomised double blind multidose pilot study of etanercept in 18 patients with NYHA III heart failure | Etanercept was well tolerated and higher doses were associated with significant improvements in quality of life scores, 6 minute walk test, and left ventricular ejection fraction | Yes43 |
| Bozkurt et al | Randomised double blind multidose pilot study of etanercept in 47 patients with NYHA III–IV heart failure | Etanercept was well tolerated with a significant improvement in echocardiographic measures of left ventricular function and a weak non-significant (p=0.20) trend towards improvement in the combined clinical end point | Yes44 |
| RENAISSANCE and RECOVER | North American and European limbs of a randomised controlled trial examining two dosage regimes of etanercept in 1500 patients with NYHA II–IV heart failure and an ejection fraction <30% | Terminated early owing to futility, with no likelihood of treatment benefit in the primary composite end point of NYHA class, patient global assessment, hospital admission, and death | No |
| ATTACH | A pilot randomised controlled trial evaluating infliximab in 150 patients with stable NYHA III–IV heart failure, ejection fraction <35%, and no concurrent infections | No difference in clinical status at 14 weeks with no benefit at 28 weeks; a trend towards worsening clinical status in the treatment group | No |