Non-specific immunomodulation may help treat heart failure

Evidence suggests that inflammatory mediators contribute to development and progression of chronic heart failure and immunomodulation might counteract this pathophysiological mechanism in patients. In a study published in the Lancet, patients with congestive heart failure were randomly assigned to receive IMT (n=1213) or placebo (n=1213). Researchers took anticoagulated blood from patients in the IMT group and exposed the blood to ozone and ultraviolet light at 42°C for 20 min, and then injected the blood back into the donor intramuscularly on days 1, 2, and 14 and then every 28 days for at least 22 weeks. The composite primary endpoint was time to hospitalisation for a cardiovascular event or death from any cause. This composite was not modified by the intervention (hazard ratio 0·92, 95% CI 0·80—1·05). During a mean follow-up of 10·2 months, there were 399 primary events in the IMT group and 429 in the placebo group (hazard ratio 0·92; p=0·22). In two prespecified subgroups of patients—those with no history of previous myocardial infarction (n=919) and those with NYHA II heart failure (n=689)—IMT was associated with a 26% (HR 0·74; p=0·02) and a 39% (HR 0·61; p=0·0003) reduction in the risk of primary endpoint events, respectively. The findings suggest a role for non-specific immunomodulation as a potential treatment for a large segment of the heart failure population, however, this hypothesis needs to be tested in an adequately powered confirmatory trial, the researchers concluded. Reference...