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