Evaluating the Efficacy, Safety, and Tolerability of Serelaxin When Added to Standard Therapy in Asian Patients With Acute Heart Failure: Design and Rationale of RELAX-AHF-ASIA Trial

J Card Fail. 2017 Jan;23(1):63-71. doi: 10.1016/j.cardfail.2016.10.016. Epub 2016 Nov 4.

Abstract

Background: Acute heart failure (AHF), a common and growing health concern worldwide, is associated with high risk of post-discharge rehospitalization and mortality. Existing evidence indicates potential therapeutic benefits of serelaxin in Caucasian AHF patients, but corresponding data in Asians remain scarce. RELAX-AHF-ASIA, a multinational, randomized, double-blind, placebo-controlled, phase III trial, will evaluate the effects of serelaxin on symptom relief and clinical outcomes in Asian AHF patients, with the use of novel assessments.

Methods and results: Patients with AHF, systolic blood pressure ≥125 mm Hg, and mild to moderate renal dysfunction will be randomized within 16 hours of presentation to receive 48-hour intravenous infusion of 30 µg ⋅ kg-1 ⋅ d-1 serelaxin or placebo in addition to standard therapy. The composite primary end point includes: (1) treatment success (moderate/marked improvement in patient-reported dyspnea and physician-assessed signs of congestion on day 2); (2) treatment failure (in-hospital worsening of signs and/or symptoms of heart failure [HF] requiring intensification of intravenous HF therapy or mechanical ventilation, renal/circulatory support, rehospitalization due to HF/renal-failure, or death through day 5); and (3) unchanged status. Secondary end points include time to in-hospital worsening HF through day 5 and all-cause and cardiovascular deaths through day 180.

Conclusions: RELAX-AHF-ASIA, the largest randomized clinical trial in Asian AHF patients to date, has a novel composite primary end point and the potential to become a hallmark of AHF trials.

Keywords: Asian; Serelaxin; acute heart failur; efficacy.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Aged
  • Asia / epidemiology
  • Cardiovascular Agents / therapeutic use*
  • Cause of Death / trends
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Drug Therapy, Combination
  • Drug Tolerance*
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Humans
  • Incidence
  • Infusions, Intravenous
  • Male
  • Middle Aged
  • Recombinant Proteins / administration & dosage
  • Relaxin / administration & dosage*
  • Survival Rate / trends
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Recombinant Proteins
  • serelaxin protein, human
  • Relaxin