Nesiritide

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Nesiritide
JSmol)
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Nesiritide, sold under the brand name Natrecor, is the

renin–angiotensin–aldosterone system, stimulating cyclic guanosine monophosphate, leading to smooth muscle
cell relaxation.

Nesiritide was believed initially to be beneficial for acute decompensated congestive heart failure. It received approval from the United States' Food and Drug Administration for this purpose in 2001 after initial non-approval. In July 2011, the results of the largest study so far for nesiritide was published in The New England Journal of Medicine. The study failed to show a difference between nesiritide and placebo on mortality or re-hospitalizations.[1]

Administration

Nesiritide is only administered

mg
/kg followed by a continuous IV infusion of 0.01 mg/kg/min. This may be increased every three hours for a maximum of 0.03 mg/kg/min.

Controversy

In 2005, after several academic papers published by

Jonathan Sackner-Bernstein[2][3][4] on the efficacy and side effects of nesiritide, Johnson & Johnson met with the FDA and altered its stated plans for the drug and agreed to revise its labeling.[5][6]

Heart doctors at the Cleveland Clinic then voted unanimously not to permit the prescription of the drug to its patients.[6] Johnson and Johnson convened a panel of experts whose advice included the recommendation to conduct the large-scale clinical trial that was subsequently published in 2011.[7] Following this, the United States Department of Justice announced an inquiry into the marketing of the drug[8] that led to a fine against the Scios unit of J&J.[9]

Side effects

Common side effects include:

More rare side effects include:

References

  1. PMID 21732835. Archived
    (PDF) from the original on 2021-02-11. Retrieved 2019-04-05.
  2. PMID 15781736
    .
  3. PMID 15840865
    .
  4. PMID 17003394
    .
  5. ^ Saul S (17 May 2005). "The Marketing and Success of Natrecor". The New York Times. Archived from the original on 4 September 2021. Retrieved 17 February 2017 – via NYTimes.com.
  6. ^ a b Saul S (4 May 2005). "Heart Clinic May End or Curtail Use of a Drug". The New York Times. Archived from the original on 4 June 2019. Retrieved 4 June 2019 – via NYTimes.com.
  7. ^ Herper M (14 June 2005). "Bitter Pill For J&J On Heart Drug". Forbes. Archived from the original on 17 May 2022. Retrieved 17 May 2022.
  8. ^ Saul S (21 July 2005). "U.S. Looking at Marketing by Johnson & Johnson". The New York Times. Archived from the original on 23 March 2021. Retrieved 17 February 2017 – via NYTimes.com.
  9. ^ "Johnson & Johnson Subsidiary Scios Pleads Guilty to Misbranding Heart Failure Drug Natrecor". www.justice.gov. 5 October 2011. Archived from the original on 12 June 2021. Retrieved 31 July 2018.
  10. ^ "Natrecor Adverse Reactions - Epocrates Online". online.epocrates.com. Archived from the original on 2020-03-08. Retrieved 2012-12-18.

Further reading

External links
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