Anaritide

Summary

Anaritide (ANP 4-28) is a 25-amino acid synthetic analog of human atrial natriuretic peptide investigated for acute renal failure and heart failure. Clinical trials, including a large Phase III trial in acute renal failure (anastasis trial), failed to demonstrate significant clinical benefit over placebo, and development was discontinued.

Mechanism of Action

Synthetic analog of atrial natriuretic peptide (ANP); binds natriuretic peptide receptors (NPR-A), activating guanylyl cyclase and increasing intracellular cGMP, leading to vasodilation, natriuresis, diuresis, and inhibition of the renin-angiotensin-aldosterone system

Routes of Administration

Goals & Uses

• Inhibition of RAASNeurohormonal ModulationModerate
• Vasodilation / blood pressure reductionCardiovascularModerate
• Natriuresis and diuresisFluid/electrolyte ManagementModerate
• Acute heart failure managementCardiovascularLow
• Treatment of acute renal failureRenal ProtectionLow

Contraindications

• Hypersensitivity to anaritide or ANP analogsImmunologicHigh
• Cardiogenic shockCardiovascularHigh
• HypotensionCardiovascularHigh

Adverse Effects

• Injection site reactionsLocalUncommon
• HeadacheNeurologicUncommonPain in the head or upper neck
• Electrolyte disturbancesMetabolicUncommon
• HypotensionCardiovascularCommonLow blood pressure
• FlushingVascularUncommonWarmth and redness of the skin

Drug Interactions

• NSAIDsLowMay increase renal risk in susceptible patients
• AntihypertensivesModerateMay potentiate hypotensive effects in some contexts
• DiureticsModerateMay worsen dehydration or electrolyte imbalance

Population Constraints

• PregnancyReproductive SafetyRelative
• Pediatric patientsAgeRelative
• Severe hypotension or hemodynamic instabilityCardiovascularAbsolute

Regulatory Status

• European UnionUnapprovedNo marketing authorization pursued following failed pivotal trial
• United StatesUnapprovedFailed Phase III clinical trial; NDA never submitted; development discontinued in the 1990s
• United KingdomUnapprovedNo approval; development abandoned globally

Never received regulatory approval in any major jurisdiction. Development was halted following negative Phase III clinical trial results in acute renal failure in the 1990s.

Evidence & Sources

No sources recorded yet.