Anakinra Versus Placebo for the Treatment of Acute MyocarditIS

Inclusion Criteria:

• Patients hospitalized for Acute myocarditis defined as:
• Chest Pain (or modification of the ECG) AND Troponin Rise (*1.5 Normal range) ANDMyocarditis proven by MRI in the first 72h after admission
• Age > 18 and <65 years old
• Accepting effective contraception during treatment duration (men and womenchildbearing potential)
• Signed informed consent Normal Coronary angiography or coronary CT Scan (made duringthe previous year is acceptable) (normal is defined as stenosis < 50%) (In the case ofpatients under 40 with typical MRI of myocarditis, coronary angiography is notmandatory and left to the doctor's discretion)

Exclusion Criteria:

• Active coronary disease
• Clinical Suspicion or proven underlying disease: systemic lupus, antiphospholipidantibodies, Lyme disease, trypanosomiase disease, myositis, signs of sarcoidosis,giant cell myocarditis, treated chronic inflammatory disease, tuberculosis, HIV,hepatitis B virus (HBV) or hepatitis C virus (HCV), Hepatitis B virus (HBV) infection,
• Latex allergy
• Pregnancy, breastfeeding
• Contra-indication to ANAKINRA (known hypersensitivity to the active substance or toany of the excipients, neutropenia < 1,5.10^9/L)
• Renal failure, Creatine Clearance (CrCl) < 30 ml/min (MDRD)
• Malignancy or any comorbidity limiting survival or conditions predicting inability tocomplete the study
• History of malignancy
• Non Steroidian Anti Inflammatory drug within the past 14 days
• Anti Tumor Necrosis Factor (TNF) within the past 14 days
• No affiliation to the French Health Care System "sécurité sociale"
• Hepatic impairment = Child-Pugh Class C
• Mechanical ventilation
• Circulatory assistance