Development of new drugs for treatment of heart failure (adventures, disasters and joys)

Abstract

Heart failure (HF) represents an important healthcare problem due to its high prevalence, high rates of hospitalization and mortality, and significant healthcare costs. HF comprises a heterogeneous group of syndromes with different pathophysiology, clinical presentation, and response to treatment. In recent years, multiple therapeutic targets implicated in the pathogenesis of HF have been identified and numerous drugs have been developed against multiple targets. But despite important advances in the pharmacological treatment of HF with reduced ejection fraction, no treatment has convincingly shown to date to reduce mortality in HF patients with preserved ejection fraction. Furthermore, the vast majority of drugs that appeared very promising in animal models or in phase 2 clinical trials have not been able to be commercialized due to their lack of efficacy and / or safety in large phase 3 clinical trials. In this article we analyze the objectives of the treatment of HF, the progress made in recent years and the possible causes that could explain our repeated failures.