Serelaxin: insights into its haemodynamic, biochemical, and clinical effects in acute heart failure

Treatment for acute heart failure (AHF) has not changed much in the last two decades.1 Intravenous drugs such as levosimendan, nesiritide, rolofylline and tezosentan have been studied in phase III randomized controlled trials (RCTs) with disappointing results. None of these drugs improved dyspnoea, worsening heart failure, readmissions to the hospital, cardiovascular mortality or all-cause mortality in AHF patients, mostly in the short-term follow-up.1 These drugs increased the probability of ventricular and atrial arrhythmias or symptomatic hypotension (levosimendan, nesiritide), or seizures and strokes (rolofylline). Ularitide, a novel natriuretic peptide, is undergoing a phase III RCT focused on symptoms and cardiovascular mortality. Several reasons for negative results are possible, including high heterogeneity of patients with AHF, several sources of bias in RCTs, scarcity of outcomes, and incomplete pre-clinical evaluation of drugs.
Authors: Hernandez, Adrian V.
Source: European Heart Journal
URL: http://hdl.handle.net/10757/322408