"BNP" for Heart Failure
B-type natriuretic peptide, or nesiritide, recently gained US Food and Drug Administration approval as the first new parenteral agent approved for heart failure therapy in more than a decade. Nesiritide refers to a peptide identical to endogenous B-type natriuretic peptide, currently manufactured by recombinant DNA technology. Nesiritide has been evaluated in clinical trials involving more than 700 subjects. The drug produces a prompt fall in systemic vascular resistance and pulmonary capillary wedge pressure, associated with rapid clinical improvement in decompensated heart failure. Nesiritide represents an attractive choice for "first-line therapy" of acutely decompensated heart failure patients. In this review, the authors summarize the currently available data regarding the use of nesiritide, and offer recommendations for its use based on our experience with the compound in clinical trials.
Despite dramatic advances in heart failure management over the past two decades, clinical cardiologists face the prospect of ever-increasing numbers of patients suffering from chronic heart failure. These patients continue to require repeated hospital admissions and consume a substantial segment of the health care budget. Both the pharmaceutical industry and the medical profession, therefore, continue to search for new and more effective pharmacotherapies.
In the course of several recent clinical trials, we had the opportunity to accumulate substantial experience with the use of human B-type natriuretic peptide (hBNP) for the treatment of patients with decompensated heart failure. To share this experience, we will review the structure and nomenclature of hBNP, its physiologic role, its pharmacologic effects, and data from clinical trials using it in heart failure treatment. Finally, we will speculate on a possible role for the compound in our therapeutic armamentarium.
B-type natriuretic peptide, or nesiritide, recently gained US Food and Drug Administration approval as the first new parenteral agent approved for heart failure therapy in more than a decade. Nesiritide refers to a peptide identical to endogenous B-type natriuretic peptide, currently manufactured by recombinant DNA technology. Nesiritide has been evaluated in clinical trials involving more than 700 subjects. The drug produces a prompt fall in systemic vascular resistance and pulmonary capillary wedge pressure, associated with rapid clinical improvement in decompensated heart failure. Nesiritide represents an attractive choice for "first-line therapy" of acutely decompensated heart failure patients. In this review, the authors summarize the currently available data regarding the use of nesiritide, and offer recommendations for its use based on our experience with the compound in clinical trials.
Despite dramatic advances in heart failure management over the past two decades, clinical cardiologists face the prospect of ever-increasing numbers of patients suffering from chronic heart failure. These patients continue to require repeated hospital admissions and consume a substantial segment of the health care budget. Both the pharmaceutical industry and the medical profession, therefore, continue to search for new and more effective pharmacotherapies.
In the course of several recent clinical trials, we had the opportunity to accumulate substantial experience with the use of human B-type natriuretic peptide (hBNP) for the treatment of patients with decompensated heart failure. To share this experience, we will review the structure and nomenclature of hBNP, its physiologic role, its pharmacologic effects, and data from clinical trials using it in heart failure treatment. Finally, we will speculate on a possible role for the compound in our therapeutic armamentarium.