Vaduganathan M, et al. - Whether treatment-related changes in natriuretic peptides (NPs) can serve as a predictor for longer-term therapeutic effects in clinical trials of heart failure (HF) was determined in this trial-level analysis of 16 phase 3 chronic HF trials completed between 1987 and 2013 studying 18 therapeutic comparisons among 48,844 patients. Researchers found a modest correlation of therapy-related changes in NPs with longer-term therapeutic effects on hospitalization for HF, but no correlation was seen with effects on all-cause mortality when a broad range of interventions was being assessed. These data raise important caveats regarding the use of NPs in phase II trials for decision making regarding phase 3 trials.