Serelaxin in the Treatment of Acute Heart Failure

The incidence and mortality associated with acute heart failure (AHF) remain high despite tremendous progress in the treatment of chronic heart failure. Novel approaches to AHF management are needed to improve outcomes. Serelaxin, a recombinant form of human relaxin-2, is a vasoactive peptide hormone with hemodynamic and neurohormonal effects. Serelaxin’s major clinical trials (Pre-RELAX-AHF and RELAX-AHF) demonstrate efficacy in improving heart failure symptoms, decreasing hospital length of stay and reducing morality at 180 days. The AHF patients included in these trials represent a specific and prevalent cohort, briefly those who present with dyspnea, elevated natriuretic peptide levels, systolic blood pressures greater than 125 mmHg, and mild-to-moderate renal insufficiency. Early serelaxin treatment is associated with less end-organ damage and improved outcomes. Serelaxin holds promise as a novel therapeutic for the treatment of AHF and two large additional Phase III trials are underway to confirm and extend these prior results.