American Heart Journal
Volume 151, Issue 4 , Page e1, April 2006

Is nesiritide really that good or that bad?

George Washington University Medical Center, Washington, DC 20037

Article Outline

 

To the Editor:

The article by Fitzgerald et al1 on the use of nesiritide seems to be contradictory to a recent editorial by Topol.2 Fitzgerald et al concluded that their study “showed a significant difference in improved sense of well-being as determined by dyspnea and global assessment scores, in patients receiving 48 hours of therapy as compared with 24 hours.”1

On the other hand, citing the articles by Sackner-Bernstein et al3, 4 and Teerlink and Massie,5 Topol concluded that, “In my view, nesiritide has not yet met the minimal criteria for safety and efficacy. Until a trial definitively proves that this drug reduces the risk of death or repeated hospitalization for heart failure, there will be questions about the appropriateness of the drug's use or even commercial availability.”2

The question that every clinician likes to be answered now is “Is nesiritide really as good as Fitzgerald et al1 asserted or as bad as Topol2 claimed?”

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References 

  1. Fitzgerald RL, Cremo R, Gardetto N, et al. Effect of nesiritide in combination with standard therapy on serum concentrations of natriuretic peptides in patients admitted for decompensated congestive heart failure. Am Heart J. 2005;150:471–477
  2. Topol EJ. Nesiritide—not verified. N Engl J Med. 2005;353:113–116
  3. Sackner-Bernstein JD, Kowalski M, Fox M, et al. Short-term risk of death after treatment with nesiritide for decompensated heart failure. JAMA. 2005;293:1900–1905
  4. Sackner-Bernstein JD, Skopicki HA, Aaronson KD. Risk of worsening renal function with nesiritide in patients with acutely decompensated heart failure. Circulation. 2005;111:1487–1491
  5. Teerlink JR, Massie BM. Nesiritide and worsening of renal function: the emperor's new clothes?. Circulation. 2005;111:1459–1461

PII: S0002-8703(05)01000-8

doi:10.1016/j.ahj.2005.11.002

Refers to article:

  • Effect of nesiritide in combination with standard therapy on serum concentrations of natriuretic peptides in patients admitted for decompensated congestive heart failure

    Robert L. Fitzgerald, Rosemary Cremo, Nancy Gardetto, Albert Chiu, Paul Clopton, Vikas Bhalla, Alan S. Maisel
    American Heart Journal September 2005 (Vol. 150, Issue 3, Pages 471-477)

American Heart Journal
Volume 151, Issue 4 , Page e1, April 2006

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