Nesiritide Has Small, Nonsignificant Effect on Dyspnea

Nesiritide use not linked to changes in rate of deaths or rehospitalization

WEDNESDAY, July 6 (HealthDay News) -- Use of nesiritide has a small, nonsignificant effect on dyspnea in patients with acute heart failure, and is not associated with changes in rates of death and rehospitalizations, according to a study published in the July 7 issue of the New England Journal of Medicine.

Christopher M. O'Connor, M.D., from the Duke University Medical Center in Durham, N.C., and colleagues investigated renal toxicity and mortality associated with nesiritide use in patients with acute heart failure. A total of 7,141 patients hospitalized for acute heart failure were randomly assigned to receive nesiritide or placebo for 24 to 168 hours along with standard care. Changes in dyspnea at six and 24 hours, and a composite of rehospitalization for heart failure or death within 30 days were the primary end points.

The investigators found that patients receiving nesiritide more frequently reported a marked or moderate improvement in dyspnea at six and 24 hours (44.5 versus 42.1 percent and 68.2 versus 66.1 percent, respectively); however, these findings did not meet the prespecified criteria for significance. The rehospitalization rate for heart failure or death from any cause within 30 days was not significantly different in the nesiritide or placebo group (9.4 versus 10.1 percent, respectively). There was no significant difference between the groups for rates of death from any cause at 30 days, or worsening renal function as defined by a 25 percent decrease in glomerular filtration.

"On the basis of these results, nesiritide cannot be recommended for routine use in the broad population of patients with acute heart failure," the authors write.

The study was supported by Scios; several authors disclosed financial relationships with various pharmaceutical companies, including Scios.

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