Pharmacological reasons that may explain why randomized clinical trials have failed in acute heart failure syndromes

Abstract Acute heart failure (AHF) represents a clinical challenge as it encloses a heterogeneous group of syndromes (AHFS) with different pathophysiology, clinical presentations, prognosis and response to therapy. In the last 25 years multiple therapeutic targets have been identified and numerous n...

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Bibliographic Details
Published in:International journal of cardiology 2017-04, Vol.233, p.1-11
Main Authors: Tamargo, Juan, Rosano, Giuseppe M.C, Delpón, Eva, Ruilope, Luis, López-Sendón, Jose
Format: Article
Language:English
Subjects:
Acute Disease
Acute heart failure syndromes
Acute heart failure therapy
Cardiovascular
Cardiovascular Agents - therapeutic use
Clinical trials
Drug development
Heart Failure - drug therapy
Humans
Pharmacology
Randomized Controlled Trials as Topic - methods
Syndrome
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Summary:Abstract Acute heart failure (AHF) represents a clinical challenge as it encloses a heterogeneous group of syndromes (AHFS) with different pathophysiology, clinical presentations, prognosis and response to therapy. In the last 25 years multiple therapeutic targets have been identified and numerous new drugs were evaluated but, up to now, all failed to demonstrate a consistent benefit on clinical outcomes. Moreover, a repeated finding has been the poor correlation between the encouraging results of preclinical and early clinical trials and the lack of effect on outcomes observed in phase III trials. We review several possible pharmacological reasons that may explain the lack of success to develop new drugs and the pharmacological challenges to overcome in the future to develop new more effective and safer drugs for the treatment of AHFS.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2016.11.124