Response to Letter Regarding Article, “Hydralazine and Isosorbide Dinitrate in Heart Failure: Historical Perspectives, Mechanisms, and Future Directions”
Year: 2011
Type: article
Abstract: We appreciate the careful review by Drs Taylor, Hare, and Mann of our article 1 and their thoughtful letter in response to it. The importance of studying the combination of hydralazine and isosorbide dinitrate in heart failure has been highlighted both by our review and by their letter. It is not uncommon for drug research and development to fall into either of the 2 following scenarios. Some drugs may enter phase III trials without a comprehensive understanding of their systemic and organ-specific mechanistic effects. In addition, their potential for differential impact on specific clinical and demographic subgroups is largely unrecognized. Alternatively, novel agents may never enter definitive trials because the multitude of questions that need to be answered in phase I and II studies may be deemed too unattractive financially, leading to the shelving of novel agents. The scientific community finds itself in an unusually good position with hydralazine and isosorbide dinitrate use in heart failure because of the wealth of clinical and translational research data that have accumulated over the years in this respect. Many data elements needed for effective clinical trial design with respect to specific aims or target groups of interest are already available. These include biological mechanisms of action, race, and sex-related signals, data on genetic heterogeneity, and specific clinical scenarios, eg, chronic versus acute heart failure. Moreover, existing data are largely encouraging, suggesting that further investment in studying this combination will likely be of societal benefit, will be less risky, and will help to further our aim of moving toward personalized medicine.
Source: Circulation
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2016375152