Drug Promising For Acute Heart Failure

	April 6, 1999 - A genetically engineered 
version of a human heart hormone may offer a new 
treatment for acute CHF and could reduce hospital 
re-admissions for heart failure, according to 
studies presented at the 8th International 
Congress on Cardiovascular Pharmacotherapy.
	The drug, nesiritide (Natrecor), is a form 
of the cardiac hormone human b-type natriuretic 
peptide (hBNP). Although not yet available in the 
USA, the drug was recommended for approval in 
February by an advisory committee of the FDA, 
which usually follows the advice of such panels.
	Nesiritide strengthens the body's natural 
response to heart failure, and rapidly improves the 
status of most patients, reports Dr. Henry Dargie of 
the Western Infirmary in Glasgow. In CHF, the 
heart is not efficient, causing shortness of breath, 
fatigue, and accumulation of fluid in the limbs and 
lungs. The condition can be chronic or acute - in 
which heart function declines very fast.
	"This is the first new treatment for acute 
heart failure for a long time," Dargie said. "For 
the last 10 years, almost all of the work in heart 
failure has been concentrated on chronic heart 
failure. Major advances such as ACE inhibitors and 
beta-blockers have proved more difficult to use in 
acute heart failure - a problem that practicing 
hospital doctors have to deal with daily," he said.
	Natriuretic peptides such as hBNP are part 
of the body's natural defense against heart failure. 
Released in response to a failing heart, they 
produce beneficial responses such as dilation of 
blood vessels to reduce the heart's workload and 
increased urine production to reduce excess fluid 
volume. However, in many acute CHF patients, this 
natural response fails to reverse the symptoms of 
heart failure.
	First-line treatment of acute heart failure 
with Natrecor may lead to lower healthcare costs, 
according to the results of a 21-day study in which 
patients who received Natrecor were less likely to 
be re-admitted to the hospital for CHF than similar 
patients treated with the commonly used cardiac drug 
dobutamine, Dr. Marc Silver reported.
	In another study, Dr. Uri Elkayam of the 
University of Southern California and the Nesiritide 
Study Group, said that Natrecor rapidly improved 
symptoms of heart failure and overall clinical status 
within 6 hours of intravenous use.
	Nesiritide was developed by Scios. Worldwide 
marketing rights were licensed to Bayer AG in Germany
last summer.