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Record W4399010918 · doi:10.1038/s41591-024-03043-1

IL-6 inhibition with clazakizumab in patients receiving maintenance dialysis: a randomized phase 2b trial

2024· article· en· W4399010918 on OpenAlexafffund
Glenn M. Chertow, Anna Marie Chang, G. Michael Felker, Mark Heise, Elena Velkoska, Bengt Fellström, David M. Charytan, Regina Clementi, C. Michael Gibson, Shaun G. Goodman, Meg Jardine, Adeera Levin, Yuliya Lokhnygina, Jenny Mears, Roxana Mehran, Peter Stenvinkel, Angela Yee‐Moon Wang, David C. Wheeler, Carmine Zoccali, Paul M. Ridker, Kenneth W. Mahaffey, Pierluigi Tricoci, Myles Wolf

Bibliographic record

VenueNature Medicine · 2024
Typearticle
Languageen
FieldMedicine
TopicDialysis and Renal Disease Management
Canadian institutionsUniversity of British ColumbiaUniversity of TorontoUniversity of Alberta
FundersNational Heart, Lung, and Blood InstituteAmerican RegentCytoSorbents EuropeCSL LimitedLG ChemIdorsia PharmaceuticalsJewish General HospitalNovo NordiskCanada Excellence Research Chairs, Government of CanadaFondation LeducqHorizon TherapeuticsGaldermaReCor MedicalSanofiAbiomedIonis PharmaceuticalsZogenixNational Institutes of HealthRegeneron PharmaceuticalsBoston Scientific CorporationCSL BehringCleveland ClinicBristol-Myers SquibbEli Lilly and CompanyAmarin CorporationAstraZenecaAtriCureDuke Clinical Research InstituteAstellas PharmaCytokineticsUniversity of TorontoAlexion PharmaceuticalsEsperion TherapeuticsAlnylam PharmaceuticalsDaiichi Sankyo EuropeServierGilead SciencesKowa CompanyAmgenHLS TherapeuticsLivaNovaYork UniversityPfizer
KeywordsMedicineRandomized controlled trialDialysisInternal medicineIntensive care medicine

Abstract

fetched live from OpenAlex

Abstract Inflammation mediated by interleukin-6 (IL-6) is strongly associated with cardiovascular risk. Here we evaluated clazakizumab, a monoclonal antibody targeting the IL-6 ligand, in a phase 2b dose-finding study. Adults with cardiovascular disease and/or diabetes receiving maintenance dialysis with high-sensitivity C-reactive protein (hs-CRP) ≥ 2 mg l −1 at baseline were randomized to receive clazakizumab (2.5 mg, 5 mg or 10 mg, n = 32 per dose group) or placebo ( n = 31) every 4 weeks. The primary endpoint was the change from baseline in hs-CRP to week 12, expressed as the geometric mean ratio. Clazakizumab treatment signficantly reduced serum hs-CRP concentrations at week 12 by 86%, 90% and 92% relative to placebo in patients randomized to 2.5 mg, 5 mg or 10 mg clazakizumab, respectively (all P < 0.0001), meeting the primary outcome. With regard to secondary endpoints, clazakizumab treatment reduced serum fibrinogen, amyloid A, secretory phospholipase A2, and lipoprotein(a) concentrations, as well as increased mean serum albumin concentrations at 12 weeks, relative to placebo. The proportion of patients who achieved hs-CRP < 2.0 mg l −1 was 79%, 82% and 79% in the 2.5 mg, 5 mg and 10 mg clazakizumab groups, respectively, compared with 0% of placebo-treated patients. With regard to safety, no cases of sustained grade 3 or 4 thrombocytopenia or neutropenia were observed. Serious infections were seen with similar frequency in the placebo, clazakizumab 2.5 mg and clazakizumab 5 mg groups, but were numerically more frequent in the clazakizumab 10 mg group. The results of this trial indicate that in patients receiving maintenance dialysis, clazakizumab reduced inflammatory biomarkers associated with cardiovascular events. ClinicalTrials.gov registration: NCT05485961 .

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.054
Threshold uncertainty score0.591

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.006
GPT teacher head0.281
Teacher spread0.275 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations77
Published2024
Admission routes2
Has abstractyes

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