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A new genetically engineered drug should soon be available to treat patients who need to be hospitalized for CHF.
Approval for nesiritide, a synthetic form of human b-type natriuretic peptide given intravenously, is still pending with the U.S. Food and Drug Association (FDA). It was recommended for approval by the Cardiovascular and Renal Drugs Advisory Committee to the FDA in January, says William Abraham, MD, nesiritide researcher and director of the heart failure and transplantation section at the University of Cincinnati. It may become available in June or July.
Abraham says early in CHF development, the heart does a good job compensating for its diminishing performance with its vasodilating hormones. But as the heart continues to fail, other hormones are released that trigger vasoconstriction. Both dilating and constricting hormones are released at the same time.
"The theory is vasoconstrictors win out," he says, adding the drug helps overcome the vasoconstriction and also has diuretic properties.
Nesiritide will be produced with the brand name Natrecor and be marketed by Bayer AG for Scios, Inc.
"This really is a useful addition to our armamentation," he says, adding anything doctors can do to get patients to leave the hospital and not return in worse shape is a worthy goal.
At the March scientific session of the American College of Cardiology, Abraham’s research team reported the drug lessened symptoms in patients with severe and moderate histories of CHF. Pulmonary capillary wedge pressure and cardiac index also were improved.
Abraham says scientists have isolated at least five natriuretic peptides. Studies to produce other drugs are continuing. It’s still not known if there will be any differences in effectiveness according to the race of the patients who use it.