As data mount against it, the case for inhibiting cytokines as a method of treating congestive heart failure may be fading. Last week, Johnson & Johnson subsidiary Centocor Inc. placed a Phase II trial of Remicade infliximab in CHF on hold. The company had seen no improvement in patients' status coupled with a higher incidence of mortality among those given the monoclonal antibody against tumor necrosis factor alpha (TNF).

Added to a Phase II/III failure of Immunex Corp.'s Enbrel etanercept in CHF earlier this year, the Remicade data suggest that inhibiting cytokines like TNF won't work in practice, despite the strong scientific rationale behind the idea. However, Scios Inc., which is developing a small molecule kinase inhibitor, continues to believe there are good reasons for blocking cytokines to treat CHF.