6 89 33.7c 121 46.2 Severe symptoms (reported at least once) Feeling feverish 36 13.5 20 7.6b 38 I-BET-762 in vitro 14.5 Headache 42 15.7 18 6.8c 42 16.0 Aches and pains 81 30.3 56 21.2b 79 30.2 ACET acetaminophen, FLUV fluvastatin, PLAC placebo a1°C

or more from baseline and 38.5°C or more overall b p < 0.05 vs. placebo c p ≤ 0.001 vs. placebo Compared with patients in the fluvastatin and placebo groups, patients in the acetaminophen group had a lower peak increase in body temperature and an earlier return to baseline levels (Fig. 2a). For each treatment group, the largest mean increase in temperature occurred between 24 and 48 h following ZOL infusion, and the peak value was recorded at the Day 2 evening measurement. The symptom VAS (recorded once each evening) followed a similar pattern (Fig. 2b), with peak values on Day 2, and the mean difference between placebo and acetaminophen was statistically significant

TGF-beta inhibitor at all time points (p < 0.05). In contrast, no significant differences were observed between placebo and fluvastatin. Fig. 2 Change from baseline in a mean body temperature and b VAS scores following IV zoledronic acid infusion in patients who received pretreatment with fluvastatin (fluv), acetaminophen four times daily over 3 days (acet), or placebo (plac) Inflammatory biomarkers Serum levels of inflammatory biomarkers were evaluated in 96 patients at baseline, 24 h, and 72 h. Baseline concentrations of IL-6, IFN-gamma, TNF-alpha, and hs-CRP were generally comparable across treatment groups (Table 2). The pattern of elevations of all four inflammatory biomarkers showed an increase in levels by 24 h after infusion (Day 2, morning; Table 2; Fig. 3a–d); elevations in body temperature were also reported on the morning of Day 2 (Fig. 2a). Levels of all three cytokines (IL-6, TNF-alpha, and IFN-gamma) returned to near baseline by 72 h, by which point most of the temperature Nitroxoline elevations had declined. The biomarker, CRP, continued to rise from baseline to 72 h. Table 2

Serum levels of inflammatory biomarkers   PLAC (N = 33) ACET (N = 33) FLUV (N = 30) IL-6 (pg/ml): median (min, max)a Baseline 2.0 (1, 61) 2.1 (0, 31) 2.5 (0, 8) 24 h 14.5 (2, 154) 9.7 (2, 73) 14.8 (2, 79) 72 h 3.9 (1, 160) 2.8 (1, 56) 3.5 (2, 79) TNF-alpha (pg/ml): median (min, max)b Baseline 1.9 (1, 5) 1.9 (1, 9) 1.8 (1, 7) 24 h 3.8 (1, 9) 3.7 (2, 11) 4.1 (2, 12) 72 h 2.6 (1, 7) 2.2 (0, 12) 3.8 (1, 9) IFN-gamma (pg/ml): median (min, max)c Baseline 0.6 (1, 4) 0.6 (1, 4) 0.6 (1, 2) 24 h 75.5 (1, 363) 40.7 (1, 872) 98.2 (4, 3479) 72 h 2.0 (1, 24) 1.6 (1, 12) 3.1 (1, 10) hs-CRP (mg/l): median (min, max)d Baseline 2.3 (0, 13) 2.3 (1, 8) 1.8 (0, 49) 24 h 8.0 (0, 81) 4.7 (1, 45) 7.8 (0, 77) 72 h 25.1 (0, 89) 19.3 (1, 133) 20.2 (0, 71) ACET acetaminophen, FLUV fluvastatin, hs-CRP highly sensitive C-reactive protein, PLAC placebo aIL-6 (pg/ml) normal reference range: 0.51–4.92 bTNF-alpha (pg/ml) normal reference range: less than 1.86 cIFN-gamma (pg/ml) normal reference range: less than 1.