Response to letter to the editor by Cheng

Article Outline

• References
• Copyright

The authors respond:

Our study clearly was not designed to assess safety of nesiritide. As explained on the first page of the article, the objective was to determine the effect of nesiritide, in combination with standard therapy, on the concentrations of BNP and NT-proBNP. Cheng takes our conclusion somewhat out of context. The statement he quotes begins, “Finally, while it is beyond the scope of our study to make finite conclusions with regards to the duration of treatment…” Because this study was not powered to look at outcomes, we state, “no conclusions can be made with regard to readmission or mortality.”¹

The data from our small study looking at the effect of nesiritide on BNP and NT-proBNP did show improved sense of well-being as determined by dyspnea and global assessment scores. It should be clear to most readers that this statement in no way addresses the long-term safety of nesiritide, which was not the purpose of the study.

Our study was pilot in nature and serves as preliminary data to better assess the efficacy of nesiritide. Using methods such as those we describe, it may be possible to identify biological responders and nonresponders by measuring both the parent drug (BNP) and a biomarker of response (NT-proBNP).² Laboratory monitoring of response is one way that we can potentially improve both the safety and efficacy of drugs such as nesiritide.

Back to Article Outline

References 

1. Fitzgerald RL, Cremo R, Gardetto N, et al. The effect of nesiritide in combination with standard therapy on serum concentrations of natriuretic peptides in patients admitted for decompensated congestive heart failure. J Am Heart. 2005;150:471–477
   • View In Article
2. Miller WL, Hartman KA, Burritt MF, et al. Biomarker responses during and after treatment with nesiritide infusion in patients with decompensated chronic heart failure. Clin Chem Mar. 2005;51:569–577
   • View In Article