Effects of serelaxin in patients admitted for acute heart failure: a meta-analysis
Open accessAbstract
Aims: The effectiveness and safety of 48 h intravenous 30 μg/kg/day serelaxin infusion in acute heart failure (AHF) has been studied in six randomized, controlled clinical trials. Methods and results: We conducted a fixed-effect meta-analysis including all studies of intravenous serelaxin initiated within the first 16 h of admission for AHF. Endpoints considered were the primary and secondary endpoints examined in the serelaxin phase III studies. In six randomized controlled trials, 6105 total patients were randomized to receive intravenous serelaxin 30 μg/kg/day and 5254 patients to control. Worsening heart failure to day 5 occurred in 6.0% and 8.1% of patients randomized to serelaxin and control, respectively (hazard ratio 0.77, 95% confidence interval 0.67–0.89; P = 0.0002). Serelaxin had no statistically significant effect on length of stay, or cardiovascular death, or heart or renal failure rehospitalization. Serelaxin administration resulted in statistically significant improvement in markers of renal function and reductions in both N-terminal pro-B-type natriuretic peptide and troponin. No significant adverse outcomes were noted with serelaxin. Through the last follow-up, which occurred at an average of 4.5 months (1–6 months), serelaxin administration was associated with a reduction in all-cause mortality, with an estimated hazard ratio of 0.87 (95% confidence interval 0.77–0.98; P = 0.0261). Conclusions: Administration of intravenous serelaxin to patients admitted for AHF was associated with a highly significant reduction in the risk of 5-day worsening heart failure and in changes in renal function markers, but not length of stay, or cardiovascular death, or heart or renal failure rehospitalization. Serelaxin administration was safe and associated with a significant reduction in all-cause mortality.
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Despite the RELAX-AHF trial failure, clinical benefits in haemodynamics and biomarker profile were demonstrated.
“despite the demonstration of clinical benefits in haemodynamics and biomarker profile.4,5”
From Revivifying research on relaxin receptor-targeted therapy for cardiovascular diseases (2025) · cites this paper as [4]
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- Authors
- Teerlink, J. R., Davison, B. A., Cotter, G., Maggioni, A. P., Sato, N., Chioncel, O., Ertl, G., Felker, G. M., Filippatos, G., Greenberg, B. H., Pang, P. S., Ponikowski, P., Edwards, C., Senger, S., Teichman, S. L., Nielsen, O. W., Voors, A. A., & Metra, M.
- Affiliations
- San Francisco VA Medical Center (US)
- Momentum Research (US)
- Associazione Nazionale Medici Cardiologi Ospedalieri (IT)
- Nippon Medical School Musashi Kosugi Hospital (JP)
- Carol Davila University of Medicine and Pharmacy (RO)
- University of Würzburg (DE)
- Duke University (US)
- University General Hospital Attikon (GR)
- University of California San Diego (US)
- Indiana University School of Medicine (US)
- Wroclaw Medical University (PL)
- Formerly Corthera , San Carlos, CA ,
- University of Copenhagen (DK)
- University Medical Center Groningen (NL)
- University of Brescia (IT)
- Corresponding author
- Cotter, Gad
- ORCID
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2019-12-30
- Volume
- 22
- Issue
- 2
- Pages
- 315-329
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- OpenAlex
- W2998077612
- Cited by
- 41
- References
- 26
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 8
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- serelaxin, acute heart failure, intravenous infusion, worsening heart failure, all-cause mortality, renal function, natriuretic peptides, troponin, hospital readmission, drug safety
- MeSH terms
- Acute Disease, Double-Blind Method, Heart Failure, Humans, Recombinant Proteins, Relaxin, Randomized Controlled Trials as Topic, Treatment Outcome
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