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Short-Term Therapies for Treatment of Acute and Advanced Heart Failure-Why so Few Drugs Available in Clinical Use, Why Even Fewer in the Pipeline?
P. Pollesello, T. Ben Gal, D. Bettex, V. Cerny, J. Comin-Colet, AA. Eremenko, D. Farmakis, F. Fedele, C. Fonseca, VP. Harjola, A. Herpain, M. Heringlake, L. Heunks, T. Husebye, V. Ivancan, K. Karason, S. Kaul, J. Kubica, A. Mebazaa, H. Mølgaard,...
Jazyk angličtina Země Švýcarsko
Typ dokumentu časopisecké články, přehledy
NLK
Free Medical Journals
od 2012
PubMed Central
od 2012
Europe PubMed Central
od 2012
ProQuest Central
od 2019-01-01
Open Access Digital Library
od 2012-01-01
Open Access Digital Library
od 2012-01-01
Health & Medicine (ProQuest)
od 2019-01-01
ROAD: Directory of Open Access Scholarly Resources
od 2012
PubMed
31683969
DOI
10.3390/jcm8111834
Knihovny.cz E-zdroje
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Both acute and advanced heart failure are an increasing threat in term of survival, quality of life and socio-economical burdens. Paradoxically, the use of successful treatments for chronic heart failure can prolong life but-per definition-causes the rise in age of patients experiencing acute decompensations, since nothing at the moment helps avoiding an acute or final stage in the elderly population. To complicate the picture, acute heart failure syndromes are a collection of symptoms, signs and markers, with different aetiologies and different courses, also due to overlapping morbidities and to the plethora of chronic medications. The palette of cardio- and vasoactive drugs used in the hospitalization phase to stabilize the patient's hemodynamic is scarce and even scarcer is the evidence for the agents commonly used in the practice (e.g. catecholamines). The pipeline in this field is poor and the clinical development chronically unsuccessful. Recent set backs in expected clinical trials for new agents in acute heart failure (AHF) (omecamtiv, serelaxine, ularitide) left a field desolately empty, where only few drugs have been approved for clinical use, for example, levosimendan and nesiritide. In this consensus opinion paper, experts from 26 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, The Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Turkey, U.K. and Ukraine) analyse the situation in details also by help of artificial intelligence applied to bibliographic searches, try to distil some lesson-learned to avoid that future projects would make the same mistakes as in the past and recommend how to lead a successful development project in this field in dire need of new agents.
Critical Care Orion Pharma 02101 Espoo Finland
Department of Anesthesiology and Intensive Care Medicine University of Lübeck 23562 Lübeck Germany
Department of Cardiology and Internal Medicine Nicolaus Copernicus University 87 100 Torun Poland
Department of Cardiology Århus University Hospital 8200 Århus Denmark
Department of Cardiology Dokuz Eylul University Faculty of Medicine 35340 Izmir Turkey
Department of Cardiology Medical School University of Cyprus 1678 Nicosia Cyprus
Department of Cardiology North Estonia Medical Center 13419 Tallinn Estonia
Department of Cardiology Oslo University Hospital Ullevaal 0372 Oslo Norway
Department of Intensive Care Medicine Amsterdam UMC location VUmc 081 HV The Netherlands
Heart Diseases Institute Hospital Universitari de Bellvitge 08015 Barcelona Spain
Heart Failure Clinic of S Francisco Xavier Hospital CHLO 1449 005 Lisbon Portugal
Heart Failure Unit Rabin Medical Center Tel Aviv University Petah Tikva 4941492d Israel
Intensive Care Unit National Health Service Leeds LS2 9JT UK
Transplant Institute Sahlgrenska University Hospital 413 45 Gothenburg Sweden
Citace poskytuje Crossref.org
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- $a Pollesello, Piero $u Critical Care, Orion Pharma, 02101 Espoo, Finland. piero.pollesello@orionpharma.com.
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- $a Both acute and advanced heart failure are an increasing threat in term of survival, quality of life and socio-economical burdens. Paradoxically, the use of successful treatments for chronic heart failure can prolong life but-per definition-causes the rise in age of patients experiencing acute decompensations, since nothing at the moment helps avoiding an acute or final stage in the elderly population. To complicate the picture, acute heart failure syndromes are a collection of symptoms, signs and markers, with different aetiologies and different courses, also due to overlapping morbidities and to the plethora of chronic medications. The palette of cardio- and vasoactive drugs used in the hospitalization phase to stabilize the patient's hemodynamic is scarce and even scarcer is the evidence for the agents commonly used in the practice (e.g. catecholamines). The pipeline in this field is poor and the clinical development chronically unsuccessful. Recent set backs in expected clinical trials for new agents in acute heart failure (AHF) (omecamtiv, serelaxine, ularitide) left a field desolately empty, where only few drugs have been approved for clinical use, for example, levosimendan and nesiritide. In this consensus opinion paper, experts from 26 European countries (Austria, Belgium, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Israel, Italy, The Netherlands, Norway, Poland, Portugal, Russia, Slovenia, Spain, Sweden, Switzerland, Turkey, U.K. and Ukraine) analyse the situation in details also by help of artificial intelligence applied to bibliographic searches, try to distil some lesson-learned to avoid that future projects would make the same mistakes as in the past and recommend how to lead a successful development project in this field in dire need of new agents.
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- $a Ben Gal, Tuvia $u Heart Failure Unit, Rabin Medical Center, Tel Aviv University, Petah Tikva 4941492d, Israel. bengalt@clalit.org.il.
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- $a Bettex, Dominique $u Institute of Anaesthesiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland. dominique.bettex@usz.ch.
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- $a Cerny, Vladimir $u Department of Anesthesiology, Perioperative Medicine and Intensive Care, Masaryk Hospital, J.E. Purkinje University, 400 96 Usti nad Labem, Czech Republic. vladimir.cerny@fnhk.cz.
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- $a Comin-Colet, Josep $u Heart Diseases Institute, Hospital Universitari de Bellvitge, 08015 Barcelona, Spain. josepcomin@gmail.com.
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- $a Eremenko, Alexandr A $u Department of Cardiac Intensive Care, Petrovskii National Research Centre of Surgery, Sechenov University, 119146 Moscow, Russia. aeremenko54@mail.ru.
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- 700 1_
- $a Fedele, Francesco $u Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, 'La Sapienza' University of Rome, 00185 Rome, Italy. Francesco.Fedele@uniroma1.it.
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- $a Fonseca, Cândida $u Heart Failure Clinic of S. Francisco Xavier Hospital, CHLO, 1449-005 Lisbon, Portugal. mcandidafonseca@gmail.com.
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- $a Karason, Kristian $u Transplant Institute, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden. kristjan.karason@medfak.gu.se.
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- $a Kaul, Sundeep $u Intensive Care Unit, National Health Service, Leeds LS2 9JT, UK. sunnykaul@aol.com.
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- $a Kubica, Jacek $u Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, 87-100 Torun, Poland. jkubica@cm.umk.pl.
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- $a Mebazaa, Alexandre $u Department of Anaesthesiology and Critical Care Medicine, AP-HP, Saint Louis and Lariboisière University Hospitals, Université de Paris and INSERM UMR-S 942-MASCOT, 75010 Paris, France. alexandre.mebazaa@aphp.fr.
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- $a Mølgaard, Henning $u Department of Cardiology, Århus University Hospital, 8200 Århus, Denmark. hennmoel@rm.dk.
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- $a Vrtovec, Bojan $u Advanced Heart Failure and Transplantation Center, Department of Cardiology, Ljubljana University Medical Center, SI-1000 Ljubljana, Slovenia. bojan.vrtovec@gmail.com.
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- $a Yilmaz, Mehmet B $u Department of Cardiology, Dokuz Eylul University Faculty of Medicine, 35340 Izmir, Turkey. cardioceptor@gmail.com.
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- $a Papp, Zoltan $u Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary. pappz@med.unideb.hu. HAS-UD Vascular Biology and Myocardial Pathophysiology Research Group, Hungarian Academy of Sciences, 4001 Debrecen, Hungary. pappz@med.unideb.hu.
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