TNF and hydrops fetalis: Indeed, some large international, randomized, placebo-controlled clinical trials (RECOVER [Research into Etanercept Cytokine Antagonism in Ventricular Dysfunction] and RENAISSANCE [Randomized Etanercept North American Strategy to Study Antagonism of Cytokines]) failed to reveal a powerful positive effect of anti-TNF therapy vs. placebo on clinical outcomes in HF patients (187).