Current treatments for acute heart failure: focus on serelaxin

Abstract

Acute heart failure remains an enormous health concern worldwide, and is a major cause of death and hospitalization. In spite of this, the treatment strategies for acute heart failure have remained largely unchanged for the past 2 decades. Several large randomized, placebocontrolled clinical trials have recently been conducted to attempt to improve the treatment and outcomes of acute decompensated heart failure. Some studies, including the EVEREST (tolvaptan) and ASCEND (nesiritide) showed efficacy at relieving early symptoms, but failed to improve long-term outcomes. Others, including PROTECT (rolofylline) and ASTRONAUT (aliskiren) showed little benefit in the relief of early symptoms or long-term outcomes. The recent RELAX-AHF studies using serelaxin, a recombinant form of relaxin, have shown considerable promise. Importantly, serelaxin improved congestion (dyspnea) and other early targets of acute decompensated heart failure treatment, but also improved mortality at 180 days. The purpose of this review is to provide an overview of current treatment strategies for acute decompensated heart failure, and a discussion of the recent clinical trials, with an emphasis on the serelaxin studies.

Targeting the Relaxin Pathway for Liver Disease Treatment

“…Most of these have examined the treatment of heart disease, based on the effects of relaxin on vasodilation and improved renal function. 47 A large Phase III randomised, placebo-controlled, double blind trial (RELAX-AHF) was conducted involving 1,161 patients presenting with acute heart failure. 48 Study participants were given a 48 hour infusion of recombinant human relaxin (30 µg/kg/day) or placebo, with the primary endpoints of improved dyspnoea by Likert scale or visual analogue scale.…”