Serelaxin: a potential new drug for the treatment of acute heart failure

Introduction: The incidence and mortality related to acute heart failure (AHF) have increased in the recent decades despite clinical trials of multiple agents and considerable progress in cardiovascular disease overall. Areas covered: This article reviews serelaxin, a new investigational drug in the treatment of AHF. It provides the background of the available treatments and focuses on serelaxin mechanisms, pharmacology, clinical features and its potential role in AHF. Expert opinion: Recent clinical trials of serelaxin (Pre-RELAX-AHF; RELAX-AHF) have provided a new hope in AHF. They have demonstrated significant serelaxin-related improvement in heart failure symptoms, length of hospital stay as well as mortality reduction in AHF patients. These findings were in the context of early administration in the course of AHF presentation in patients with normal or high blood pressures, thus highlighting the drug's strengths based on its molecular mechanisms of action. Overall, serelaxin is a promising therapy, and further studies aimed at reproducibility of prior results, safety and hemodynamic effects of serelaxin, as well as investigation of the molecular reasons for such effects are currently under way.