Topic
Nesiritide
About: Nesiritide is a research topic. Over the lifetime, 589 publications have been published within this topic receiving 20893 citations. The topic is also known as: Natrecor.
Papers published on a yearly basis
Papers
Duke University1, Cleveland Clinic2, University of Alberta3, Stavanger University Hospital4, Pierre-and-Marie-Curie University5, Veterans Health Administration6, University of California, San Francisco7, University of Glasgow8, Université de Montréal9, University of Gothenburg10, University of North Carolina at Chapel Hill11, Charité12, University of Oslo13, Rabin Medical Center14, Johnson & Johnson15, Emory University16, Universidade Federal do Rio Grande do Sul17, Pontifical Catholic University of Chile18, Linköping University19, MetroHealth20, University of California, Los Angeles21, Janssen Pharmaceutica22, University of Maryland, Baltimore23, University of Florida24, University of Pennsylvania25, Dalhousie University26, Ford Motor Company27, Monash University28, Vilnius University29, University of Washington30, Mexican Social Security Institute31, University of Brescia32, Seoul National University33, Mayo Clinic34, Wrocław Medical University35, Mahidol University36, University of Otago37, University of Groningen38, Thomas Jefferson University39
TL;DR: In this article, Nesiritide was not associated with an increase or a decrease in the rate of death and rehospitalization and had a small, nonsignificant effect on dyspnea when used in combination with other therapies.
Abstract: A b s t r ac t Background Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent. Methods We randomly assigned 7141 patients who were hospitalized with acute heart failure to receive either nesiritide or placebo for 24 to 168 hours in addition to standard care. Coprimary end points were the change in dyspnea at 6 and 24 hours, as measured on a 7-point Likert scale, and the composite end point of rehospitalization for heart failure or death within 30 days. Results Patients randomly assigned to nesiritide, as compared with those assigned to placebo, more frequently reported markedly or moderately improved dyspnea at 6 hours (44.5% vs. 42.1%, P = 0.03) and 24 hours (68.2% vs. 66.1%, P = 0.007), but the prespecified level for significance (P≤0.005 for both assessments or P≤0.0025 for either) was not met. The rate of rehospitalization for heart failure or death from any cause within 30 days was 9.4% in the nesiritide group versus 10.1% in the placebo group (absolute difference, −0.7 percentage points; 95% confidence interval [CI], −2.1 to 0.7; P = 0.31). There were no significant differences in rates of death from any cause at 30 days (3.6% with nesiritide vs. 4.0% with placebo; absolute difference, −0.4 percentage points; 95% CI, −1.3 to 0.5) or rates of worsening renal function, defined by more than a 25% decrease in the estimated glomerular filtration rate (31.4% vs. 29.5%; odds ratio, 1.09; 95% CI, 0.98 to 1.21; P = 0.11). Conclusions Nesiritide was not associated with an increase or a decrease in the rate of death and rehospitalization and had a small, nonsignificant effect on dyspnea when used in combination with other therapies. It was not associated with a worsening of renal function, but it was associated with an increase in rates of hypotension. On the basis of these results, nesiritide cannot be recommended for routine use in the broad population of patients with acute heart failure. (Funded by Scios; ClinicalTrials.gov number, NCT00475852.)
1,182 citations
TL;DR: Measurement of circulating concentrations of B-type natriuretic peptide and the N-terminal fragment of its prohormones and use of recombinant human BNP (nesiritide) and vasopeptidase inhibitors to treat heart failure are focused on.
1,175 citations
Journal Article•
976 citations
TL;DR: Improvements in global clinical status, dyspnea, and fatigue were sustained with nesiritide therapy for up to seven days and were similar to those observed with standard intravenous therapy for heart failure.
Abstract: Background Intravenous infusion of nesiritide, a brain (B-type) natriuretic peptide, has beneficial hemodynamic effects in patients with decompensated congestive heart failure. We investigated the clinical use of nesiritide in such patients. Methods Patients hospitalized because of symptomatic congestive heart failure were enrolled in either an efficacy trial or a comparative trial. In the efficacy trial, which required the placement of a Swan–Ganz catheter, 127 patients with a pulmonary-capillary wedge pressure of 18 mm Hg or higher and a cardiac index of 2.7 liters per minute per square meter of body-surface area or less were randomly assigned to double-blind treatment with placebo or nesiritide (infused at a rate of 0.015 or 0.030 μg per kilogram of body weight per minute) for six hours. In the comparative trial, which did not require hemodynamic monitoring, 305 patients were randomly assigned to open-label therapy with standard agents or nesiritide for up to seven days. Results In the efficacy trial, ...
922 citations
TL;DR: Nesiritide significantly increases the risk of worsening renal function in patients with acutely decompensated heart failure, and the prognostic importance of worsen renal function suggests the need for further investigation in appropriately powered clinical trials.
Abstract: Background— Renal function is an important prognostic factor for patients with acutely decompensated heart failure (ADHF). We investigated the renal effects of nesiritide as treatment for ADHF. Methods and Results— Randomized clinical trials comparing nesiritide with either placebo or active control for ADHF were identified by electronic and manual searches and thorough review of US Food and Drug Administration files available via the website. Worsening renal function was defined as an increase in serum creatinine >0.5 mg/dL. Relative risk across all studies was determined by meta-analysis with Mantel-Haenszel fixed-effects models (RRMH). Risk of dialysis and medical intervention for worsening renal function were compared between therapies. Frequency of worsening renal function was determined from 5 randomized studies that included 1269 patients. Use of Food and Drug Administration–approved doses of nesiritide (≤0.03 μg · kg−1 · min−1) significantly increased the risk of worsening renal function compared ...
809 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2025 | 1 |
| 2024 | 1 |
| 2023 | 5 |
| 2022 | 3 |
| 2021 | 5 |
| 2020 | 4 |