near-to-significanceP = 0.09
215 , 216 , 217 , 219 , 220 , 221 , 222 , 224 , 228 Finally, a small pilot randomized trial recently demonstrated that a single subcutaneous injection of canakinumab administered 60 minutes after effective electrical cardioversion in a small cohort of 11 patients with persistent AF and elevated high-sensitivity C-reactive protein levels (vs 13 with placebo) was associated to a near-to-significance ∼60% reduced risk of AF recurrence at 6-month follow-up (HR: 0.36; 95% CI: 0.11-1.15; P = 0.09), without safety concerns, including infections. 229 Notably, in none of the above-mentioned trials were cytokine levels measured, although these data are expected to be crucial for guiding a truly high-precision targeted anticytokine therapy and achieving its maximum effectiveness.