Evolving therapies for the management of chronic and acute decompensated heart failure

Jennifer C. Cook, Richard H. Tran, J. Herbert Patterson, Jo E. Rodgers

Research output: Research - peer-reviewArticle

Abstract

Purpose. The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. Summary. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, b-blockers, and aldosterone receptor antagonists, and the rates of HFrelated mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Conclusion. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation.

LanguageEnglish (US)
Pages1745-1754
Number of pages10
JournalAmerican Journal of Health-System Pharmacy
Volume73
Issue number21
DOIs
StatePublished - Nov 1 2016

Fingerprint

Heart Failure
Therapeutics
Hospitalization
Guidelines
ivabradine
Clinical Trials
Mortality
ferric carboxymaltose
LCZ 696
Mineralocorticoid Receptor Antagonists
Angiotensin Receptor Antagonists
Proxy
United States Food and Drug Administration
Angiotensin-Converting Enzyme Inhibitors
Patient Selection
Pharmacology
Safety
nitroxyl
bucindolol
sarcosine-arginyl-valyl-tyrosyl-isoleucyl-histidyl-prolyl-alanine

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy

Cite this

Evolving therapies for the management of chronic and acute decompensated heart failure. / Cook, Jennifer C.; Tran, Richard H.; Patterson, J. Herbert; Rodgers, Jo E.

In: American Journal of Health-System Pharmacy, Vol. 73, No. 21, 01.11.2016, p. 1745-1754.

Research output: Research - peer-reviewArticle

@article{74fc07283ec04edc821d013afc908e95,
title = "Evolving therapies for the management of chronic and acute decompensated heart failure",
abstract = "Purpose. The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. Summary. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, b-blockers, and aldosterone receptor antagonists, and the rates of HFrelated mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Conclusion. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation.",
author = "Cook, {Jennifer C.} and Tran, {Richard H.} and Patterson, {J. Herbert} and Rodgers, {Jo E.}",
year = "2016",
month = "11",
doi = "10.2146/ajhp150635",
volume = "73",
pages = "1745--1754",
journal = "American Journal of Health-System Pharmacy",
issn = "1079-2082",
publisher = "American Society of Health-Systems Pharmacy",
number = "21",

}

TY - JOUR

T1 - Evolving therapies for the management of chronic and acute decompensated heart failure

AU - Cook,Jennifer C.

AU - Tran,Richard H.

AU - Patterson,J. Herbert

AU - Rodgers,Jo E.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Purpose. The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. Summary. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, b-blockers, and aldosterone receptor antagonists, and the rates of HFrelated mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Conclusion. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation.

AB - Purpose. The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. Summary. HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, b-blockers, and aldosterone receptor antagonists, and the rates of HFrelated mortality and hospitalization have remained unacceptably high. In response to a demand for novel pharmacologic agents, several therapeutic compounds have recently gained approval or are currently under review by the Food and Drug Administration. Sacubitril-valsartan has demonstrated benefit in reducing cardiovascular mortality and HF-related hospitalizations in clinical trials, while ivabradine and ferric carboxymaltose have proven efficacious in reducing HF-related hospitalizations. Lastly, the role of serelaxin in ADHF is currently under investigation in an ongoing Phase III study. While large, outcome-driven clinical trials are fundamental in informing the clinical application of these therapeutic agents, careful patient selection is imperative to ensuring similar outcomes postmarketing. In addition, optimization of current guideline-directed medical therapy remains essential as new therapies emerge and are incorporated into guideline recommendations. Additional therapeutic agents currently undergoing investigation include bucindolol hydrochloride, cimaglermin alfa, nitroxyl, omecamtiv mecarbil, TRV027, and ularitide. Clinical practitioners should remain abreast of emerging literature so that new therapeutic entities are optimally applied and positive patient outcomes are achieved. Conclusion. Recently introduced agents for the treatment of patients with HF include sacubitril-valsartan, ivabradine, and ferric carboxymaltose. Additional agents worthy of attention include serelaxin and other therapies currently under investigation.

UR - http://www.scopus.com/inward/record.url?scp=84994078028&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84994078028&partnerID=8YFLogxK

U2 - 10.2146/ajhp150635

DO - 10.2146/ajhp150635

M3 - Article

VL - 73

SP - 1745

EP - 1754

JO - American Journal of Health-System Pharmacy

T2 - American Journal of Health-System Pharmacy

JF - American Journal of Health-System Pharmacy

SN - 1079-2082

IS - 21

ER -