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Use of nesiritide doesn't help or hinder, study shows
Nesiritide cannot be recommended in the broad population of patients with acute decompensated heart failure, according to the results of a recent study published in the New England Journal of Medicine.
Nesiritide cannot be recommended in the broad population of patients with acute decompensated heart failure, according to the results of a recent study published in the New England Journal of Medicine.
The Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (ASCEND-HF) trial was designed to evaluate the safety and efficacy of the drug. Primary end points included the change in dyspnea at 6 and 24 hours, as measured on a 7-point Likert scale, as well as the composite end point of rehospitalization for heart failure or death within 30 days, and renal dysfunction. The trial was conducted from May 2007 through August 2010 at 398 centers throughout the world.
More than 7,000 patients who were hospitalized with acute heart failure were randomly assigned to receive either nesiritide or placebo for 24 to 168 hours in addition to standard care.
According to the results, the observed effect of nesiritide on dyspnea in this trial was small and not significant. Patients in the nesiritide group more frequently reported an improvement in dyspnea at 6 hours (44.5% vs 42.1%, P=.03) and 24 hours (68.2% vs 66.1%, P=.007). And the drug neither increased nor decreased the rate of death and rehospitalization. The rate of rehospitalization for heart failure or death from any cause within 30 days was 9.4% in the nesiritide group versus 10.1% in the placebo group.
The authors mentioned that nesiritide was quickly approved and adopted in 2001 because of its perceived benefit in relieving dyspnea and congestion; however its use noticeably decreased after a published meta-analyses reported a detrimental effect on survival and renal function. “Our study showed that neither belief was accurate. The results of this trial highlight the urgent need for rigorously designed trials with adequate power to provide reliable estimates that can replace incomplete or inadequate evidence as a basis for therapeutic decisions,” the authors concluded.
Coalition promotes important acetaminophen dosing reminders
November 18th 2014It may come as a surprise that each year Americans catch approximately 1 billion colds, and the Centers for Disease Control and Prevention estimates that as many as 20% get the flu. This cold and flu season, 7 in 10 patients will reach for an over-the-counter (OTC) medicine to treat their coughs, stuffy noses, and sniffles. It’s an important time of the year to remind patients to double check their medicine labels so they don’t double up on medicines containing acetaminophen.
Support consumer access to specialty medications through value-based insurance design
June 30th 2014The driving force behind consumer cost-sharing provisions for specialty medications is the acquisition cost and not clinical value. This appears to be true for almost all public and private health plans, says a new report from researchers at the University of Michigan Center for Value-Based Insurance Design (V-BID Center) and the National Pharmaceutical Council (NPC).
Management of antipsychotic medication polypharmacy
June 13th 2013Within our healthcare-driven society, the increase in the identification and diagnosis of mental illnesses has led to a proportional increase in the prescribing of psychotropic medications. The prevalence of mental illnesses and subsequent treatment approaches may employ monotherapy as first-line treatment, but in many cases the use of combination of therapy can occur, leading to polypharmacy.1 Polypharmacy can be defined in several ways but it generally recognized as the use of multiple medications by one patient and the most common definition is the concurrent use of five more medications. The presence of polyharmacy has the potential to contribute to non-compliance, drug-drug interactions, medication errors, adverse events, or poor quality of life.
Medical innovation improves outcomes
June 12th 2013I have been diagnosed with stage 4 cancer of the pancreas, a disease that’s long been considered not just incurable, but almost impossible to treat-a recalcitrant disease that some practitioners feel has given oncology a bad name. I was told my life would be measured in weeks.
