Nesiritide: harmful or harmless?
Nesiritide is the recombinant form of human B-type (brain) natriuretic peptide (BNP), and its amino acid sequence is identical to that of endogenous human BNP. Administration of nesiritide results in venous and arterial vasodilation, as well as enhanced diuresis. Given the many limitations of therapies previously available for the treatment of acute decompensated heart failure, the anticipation was that nesiritide would offer a safer and more effective therapeutic option. Recently, two meta-analyses raised the question of safety with nesiritide therapy, specifically an increased risk of renal dysfunction and mortality. Although several studies generated information regarding the potential role of nesiritide in various settings, the questions raised by the meta-analyses are concerning. Our hope is that future clinical trials will address the concerns raised and provide a better understanding of the role of nesiritide in the management of acute decompensated heart failure. Until these data are available, nesiritide use should be limited.
Dorsch
Michael P
MP
Department of Pharmacy Services, University of Michigan Hospitals and Health Clinics, Ann Arbor, Michigan 48109-0008, USA. mdorsch@med.umich.edu
Rodgers
Jo Ellen
JE
D000208:Acute Disease; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007668:Kidney / Q000187:drug effects; D007902:Length of Stay; D045283:Natriuretic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D020097:Natriuretic Peptide, Brain / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D045283:Natriuretic Agents; D020097:Natriuretic Peptide, Brain