Effect of IL--1β Inhibition on Inflammation and Cardiovascular Risk

• Status: Active, not recruiting
• Trial end date: 2022-12-01
• Target enrollment: 0
• Participant gender: All

Summary

The purpose of this study is to evaluate the effects of IL-1β inhibition on safety, measures of systemic and vascular inflammation and endothelial function (all indicators of cardiovascular risk) in treated and suppressed HIV infected individuals This study will assess the safety and effects of canakinumab on endothelial function (assessed by flow-mediated vasodilation [FMD] of the brachial artery), vascular inflammation (assessed by FDG-PET/CT scanning), key inflammatory markers of cardiovascular disease (CVD) risk (high-sensitivity C-reactive protein [hsCRP]), interleukin-6 (IL-6), soluble CD163 (sCD163), D-dimer, T-cell and monocyte activation in the blood, and size of the HIV reservoir. 20 individuals will receive a single dose of 150mg canakinumab with follow-up for 18 weeks.

• Phase: Phase 2
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: Priscilla Hsue, MD; University of California, San Francisco
• Treatments: Antibodies, Monoclonal

Criteria

Inclusion Criteria:

1. HIV infection,

2. Age ≥ 40 years < 60 years

3. On continuous ART for at least 12 months with no change in regimen in 12 weeks prior to study entry

4. CD4+ T cell count ≥ 400 cells/mm3

5. HIV RNA level below the standard limit of quantification for 52 weeks prior to entry

6. High risk for CAD as defined by either documented CVD (including prior MI) or diabetes mellitus or 1 CVD risk factor (current smoking, hypertension, dyslipidemia, or hsCRP≥2mg/L.)

7. Individuals on stable doses of lipid lowering therapy and/or anti-hypertensive medication will be allowed in the study.

8. Appropriate documentation from medical records of prior receipt of pneumococcal vaccinations

Exclusion Criteria:

1. Women of childbearing potential or pregnant/nursing women

2. CABG surgery in the past 3 years

3. Class IV heart failure

4. Uncontrolled HTN

5. History of tuberculosis or latent TB that is not treated

6. Nephrotic syndrome or eGFR< 30 ml/min/1.73m2

7. Active hepatic disease or active/chronic hepatitis B or C

8. Any prior malignancy including KS

9. Serious illness requiring hospitalization or active infection requiring antibiotics within 90 days

10. Requirement for live active vaccination 3 months prior to, during, and 3 months after study

11. Concurrent immune modulating therapy

12. Diabetes Mellitus

13. History of multiple imaging studies associated with radiation exposure

14. Neutropenia defined as ANC<1500/mm

15. Triglycerides>400 mg/dL

16. History of hypersensitivity to study drug

17. History of EBV-related lymphoproliferative disorders

18. Active or untreated latent TB infection