Targeting Vascular INflammation in Patients With Community-Acquired Pneumonia

TIN CAP is a multi centre, prospective, randomized, double-blind, placebo-controlled clinical trial to evaluate the use of icosapent ethyl (Vascepa) on vascular inflammation in patients with CAP using FDG-PET/CT imaging and measurement of circulating biomarkers. The current proposal uses a randomized design to:

• measure the effect of icosapent ethyl vs. placebo on reducing arterial inflammation over a 6-month treatment period, with primary analysis at 6-months;
• the correlation between imaging and blood biomarkers over time relative to the drug response.

Inclusion criteria

Patients who have:

• Hospitalization with CAP (defined as pulmonary infiltration using chest imaging, in addition to other clinical symptoms including fever, cough, and sputum)
• age > 18 years;
• given informed consent.

Exclusion criteria

Patients who have:

• history of cancer within the last 3 years (other than a successfully treated cutaneous squamous cell or basal cell carcinoma or localized carcinoma in situ of the cervix).
• active inflammatory conditions (e.g. rheumatoid arthritis, chronic inflammatory bowel disease, SLE, systemic anti-inflammatory therapy (e.g. prednisone, methotrexate));
• pregnancy (all women of child bearing potential will have a negative BHCG test;
• breastfeeding;
• Women of childbearing potential who refuse to use two forms of contraception (this includes at least one form of highly effective and one effective method of contraception) throughout the study OR men capable of fathering a child who refuse to use contraception.
• Allergies to icosapent ethyl
• allergies to fish or shellfish
• glomerular filtration rate (GFR) <50 ml/min/1.72m2 (excluded from CTA portion)
• unable to give informed consent;

Exclusion for CTA portion of the protocol:

Patients with dye allergy will not undergo CTA but will have PET/CT