Recent and Upcoming Drug Therapies for Pediatric Heart Failure

Pediatric heart failure (HF) is an important clinical condition with high morbidity, mortality, and costs. Due to the heterogeneity in clinical presentation and etiologies, the development of therapeutic strategies is more challenging in children than adults. Most guidelines recommending drug therap...

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Main Authors: Karla L. Loss, Robert E. Shaddy, Paul F. Kantor
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-11-01
Series:Frontiers in Pediatrics
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fped.2021.681224/full
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author Karla L. Loss
Robert E. Shaddy
Paul F. Kantor
author_facet Karla L. Loss
Robert E. Shaddy
Paul F. Kantor
author_sort Karla L. Loss
collection DOAJ
description Pediatric heart failure (HF) is an important clinical condition with high morbidity, mortality, and costs. Due to the heterogeneity in clinical presentation and etiologies, the development of therapeutic strategies is more challenging in children than adults. Most guidelines recommending drug therapy for pediatric HF are extrapolated from studies in adults. Unfortunately, even using all available treatment, progression to cardiac transplantation is common. The development of prospective clinical trials in the pediatric population has significant obstacles, including small sample sizes, slow recruitment rates, challenging endpoints, and high costs. However, progress is being made as evidenced by the recent introduction of ivabradine and of sacubitril/valsartan. In the last 5 years, new drugs have also been developed for HF with reduced ejection fraction (HFrEF) in adults. The use of well-designed prospective clinical trials will be fundamental in the evaluation of safety and efficacy of these new drugs on the pediatric population. The aim of this article is to review the clinical presentation and management of acute and chronic pediatric heart failure, focusing on systolic dysfunction in patients with biventricular circulation and a systemic left ventricle. We discuss the drugs recently approved for children and those emerging, or in use for adults with HFrEF.
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spelling doaj.art-53b1d27df00c43e6acbd03d5d6a1d9152022-12-21T20:07:19ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602021-11-01910.3389/fped.2021.681224681224Recent and Upcoming Drug Therapies for Pediatric Heart FailureKarla L. LossRobert E. ShaddyPaul F. KantorPediatric heart failure (HF) is an important clinical condition with high morbidity, mortality, and costs. Due to the heterogeneity in clinical presentation and etiologies, the development of therapeutic strategies is more challenging in children than adults. Most guidelines recommending drug therapy for pediatric HF are extrapolated from studies in adults. Unfortunately, even using all available treatment, progression to cardiac transplantation is common. The development of prospective clinical trials in the pediatric population has significant obstacles, including small sample sizes, slow recruitment rates, challenging endpoints, and high costs. However, progress is being made as evidenced by the recent introduction of ivabradine and of sacubitril/valsartan. In the last 5 years, new drugs have also been developed for HF with reduced ejection fraction (HFrEF) in adults. The use of well-designed prospective clinical trials will be fundamental in the evaluation of safety and efficacy of these new drugs on the pediatric population. The aim of this article is to review the clinical presentation and management of acute and chronic pediatric heart failure, focusing on systolic dysfunction in patients with biventricular circulation and a systemic left ventricle. We discuss the drugs recently approved for children and those emerging, or in use for adults with HFrEF.https://www.frontiersin.org/articles/10.3389/fped.2021.681224/fullpediatric heart failuresacubitril/valsartanivabradineomecamtiv mecarbilheart failure reduced ejection fraction (HFrEF)
spellingShingle Karla L. Loss
Robert E. Shaddy
Paul F. Kantor
Recent and Upcoming Drug Therapies for Pediatric Heart Failure
Frontiers in Pediatrics
pediatric heart failure
sacubitril/valsartan
ivabradine
omecamtiv mecarbil
heart failure reduced ejection fraction (HFrEF)
title Recent and Upcoming Drug Therapies for Pediatric Heart Failure
title_full Recent and Upcoming Drug Therapies for Pediatric Heart Failure
title_fullStr Recent and Upcoming Drug Therapies for Pediatric Heart Failure
title_full_unstemmed Recent and Upcoming Drug Therapies for Pediatric Heart Failure
title_short Recent and Upcoming Drug Therapies for Pediatric Heart Failure
title_sort recent and upcoming drug therapies for pediatric heart failure
topic pediatric heart failure
sacubitril/valsartan
ivabradine
omecamtiv mecarbil
heart failure reduced ejection fraction (HFrEF)
url https://www.frontiersin.org/articles/10.3389/fped.2021.681224/full
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