Natrecor (nesiritide; Johnson & Johnson) is a recombinant form of human brain natriuretic peptide (BNP), a circulating hormone of cardiac origin indicated for the treatment of patients with acute decompensated heart failure (ADHF) who have dyspnea at rest or with minimal activity. BNP is naturally secreted by the ventricular myocardium in response to volume overload and increased filling pressure. It binds to the particulate guanylate cyclase receptor of vascular smooth muscle and endothelial cells, leading to increased intracellular concentrations of guanosine 3’5’-cyclic monophosphate (cGMP) and smooth muscle cell relaxation.
cGMP serves as a second messenger to dilate veins and arteries, and Natrecor causes natriuresis and a reduction in intravascular volume. The natriuretic effect results from a direct inhibition of sodium absorption in the renal collecting duct, increased glomerular infiltration, and inhibited aldosterone production and secretion. This produces a prompt fall in systemic vascular resistance and pulmonary capillary wedge pressure, associated with rapid clinical improvement in ADHF.
- Natrecor: Acute decompensated heart failure (ADHF)
Figure 1: Natrecor for ADHF - SWOT analysis
Figure 2: The author’s drug assessment summary for Natrecor in ADHF
Figure 3: The author’s drug assessment summary for Natrecor in ADHF
List of Tables
Table 1: Natrecor drug profile
Table 2: Natrecor Phase III data in ADHF