Is outpatient nesiritide safe for hypotensive heart failure patients?

Beck, William C.; Bruton, Orin; Christensen, Kerrie; Mendoza, S.; Snider, Sue E.; Tran, Drissana; Walker, Kirk W.

doi:10.1016/s1071-9164(03)00387-7

Cited by 2 publications

(5 citation statements)

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“…4 NTG dosage was titrated at investigators' discretion; at 3 h, mean NTG dose was 42 g/min in catheterized patients. In a retrospective study of 28 severe heart failure patients, Beck et al [13] looked at the feasibility and safety of nesiritide infusions in outpatients. Nesiritide at a dose of 2 g/kg bolus and 0.01 g/kg/min infusion for 4-6 h on 1 or 2 days per week was assessed.…”

Section: Outpatient Usementioning

confidence: 99%

“…Nesiritide at a dose of 2 g/kg bolus and 0.01 g/kg/min infusion for 4-6 h on 1 or 2 days per week was assessed. After approximately 449 nesiritide infusions (average 16 per patient), symptomatic hypotension occurred in 1.6% (5/315) of visits in normotensive patients and in 3.7% (5/134) of visits in hypotensive patients [13] . The overall rate of symptomatic hypotension was 2.2% (10/449) [13] .…”

Section: Outpatient Usementioning

confidence: 99%

“…After approximately 449 nesiritide infusions (average 16 per patient), symptomatic hypotension occurred in 1.6% (5/315) of visits in normotensive patients and in 3.7% (5/134) of visits in hypotensive patients [13] . The overall rate of symptomatic hypotension was 2.2% (10/449) [13] . All patients experiencing hypotension had their symptoms resolved following discontinuation of nesiritide with one exception, which required a 250-ml fl uid challenge.…”

Section: Outpatient Usementioning

confidence: 99%

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Nesiritide Usage in Decompensated Heart Failure: Cost Effectiveness and Clinical Effectiveness

Lenz¹,

Hilleman²

2005

Heart Drug

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Background: Approximately 5 million Americans have heart failure, with 550,000 new cases diagnosed each year. In the United States, approximately 500 million USD is spent annually on drug treatment for heart failure alone. Cost-effective treatment that prevents hospitalization is of high priority when treating patients with heart failure. Nesiritide, a human B-type natriuretic peptide, is indicated for the treatment of patients with acutely decompensated heart failure. Objective: The purpose of this manuscript is to provide an overview of the clinical effectiveness of nesiritide as well as the pharmacoeconomics associated with its use. Methods: Recently published articles and abstracts were identified from Pubmed, Medline and IPA using the search terms ‘nesiritide’, ‘heart failure’, ‘pharmacoeconomic’ and ‘clinical effectiveness’. Results: Randomized, multicenter trials examining the efficacy of nesiritide in patients hospitalized with decompensated heart failure have shown nesiritide to be significantly more effective than placebo and nitroglycerin at lowering pulmonary capillary wedge pressure in patients with decompensated heart failure. Nesiritide has also shown safety and efficacy when used in an outpatient setting. Additionally, four studies have examined the pharmacoeconomics associated with the use of nesiritide. All four studies showed a decreased length of stay in either intensive care and critical care units or total hospital stay, and three of the four studies performed a cost analysis which demonstrated cost savings. Conclusion: In several studies, nesiritide has been shown to be similar or significantly more effective than standard therapy at improving the status of patients with decompensated heart failure while demonstrating cost savings and decreasing length of stay.

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Section: Outpatient Usementioning

confidence: 99%

Section: Outpatient Usementioning

confidence: 99%

Section: Outpatient Usementioning

confidence: 99%

See 1 more Smart Citation

Nesiritide Usage in Decompensated Heart Failure: Cost Effectiveness and Clinical Effectiveness

Lenz¹,

Hilleman²

2005

Heart Drug

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“…A number of small studies have reported that nesiritide can be used safely in the outpatient setting as an intermittent, short-term infusion (13)(14)(15). The FUSION trial randomized 210 patients with NYHA class III/IV heart failure to standard care (which could include intermittent inotropes) or outpatient nesiritide infusions (16).…”

Section: Nesiritide Use In Ambulatory and Ed Patientsmentioning

confidence: 99%

“…We will discuss these trials, briefly cover a few other nesiritide studies, and give our recommendations regarding nesiritide use in the ED. Other analyses of nesiritide, including a preliminary study vs. placebo (10) and several presentations in abstract form only, may have potential information applicable to the ED and will be discussed briefly as well (11)(12)(13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%