Potential new drug treatments for congestive heart failure.
BACKGROUND
The prevalence of heart failure (HF) has increased globally in recent decades. Advances in our understanding of underlying pathophysiologic mechanisms have given rise to new therapies for treating the growing HF population. Nonetheless, morbidity and mortality associated with HF and its financial implications are daunting. Thus, novel therapies that can improve the natural history of HF patients are urgently needed.


METHODS
This article reviews new investigational drugs being developed for the treatment of both acute decompensated heart failure (ADHF) and chronic heart failure with reduced ejection fraction (HFrEF). It presents the background of these drugs with a focus on their mechanism of action, their pharmacology, evidence from clinical studies and their potential role in HF management.


CONCLUSIONS
The mortality benefit associated with serelaxin treatment in the RELAX-HF trial is being tested in RELAX-AHF II, while two other drugs, ularitide and TRV027, are also being evaluated in ADHF patients. Two new agents for the treatment of chronic HFrEF, LCZ696 and ivabradine, have been recently been approved for use by the FDA and four novel agents which have shown considerable promise in early studies, omecamtiv mecarbil, vericiguat, finerenone, and neuregulin, are currently being evaluated in late-phase clinical trials.
a Department of Medicine, Division of Cardiology , University of California , San Diego , CA , USA.
Hao A
HA
Tran
a Department of Medicine, Division of Cardiology , University of California , San Diego , CA , USA.
Felice
F
Lin
a Department of Medicine, Division of Cardiology , University of California , San Diego , CA , USA.
Barry H
BH
Greenberg
D000208:Acute Disease; D000818:Animals; D002317:Cardiovascular Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D015507:Drugs, Investigational / Q000494:pharmacology / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D006801:Humans
D002317:Cardiovascular Agents; D015507:Drugs, Investigational
Acute decompensated heart failure; TRV027; chronic congestive heart failure; finerenone; neuregulin; omecamtiv mecarbil; serelaxin; ularitide; vericiguat