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Home > Health Conditions > Hypertension > Entresto (sacubitril/valsartan)

Entresto (sacubitril/valsartan)

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News & Research:

  • Five Reasons Sacubitril/Valsartan Should NOT Be Approved for HFpEF - Medscape, 1/15/21
  • FDA Panel Supports Expanded HF Role for Sacubitril/Valsartan - Medscape, 12/15/20 - "The U.S. Food and Drug Administration asked its Cardiovascular and Renal Drugs Advisory Committee to broadly consider whether new analyses of data from the PARAGON-HF trial, combined with other information, could support use of sacubitril/valsartan (Entresto, Novartis) in heart failure with preserved ejection fraction (HFpEF) ... The advisory committee voted 12-1 on this question"
  • Sacubitril/Valsartan: Neprilysin Inhibition 5 Years After PARADIGM-HF - Medscape, 12/4/20 - "Sacubitril/valsartan is an efficacious, safe, and cost-effective therapy that improves quality of life and longevity in patients with chronic HFrEF and reduces hospital admission. An in-hospital initiation strategy offers a potentially new avenue to improve the clinical uptake of sacubitril/valsartan ... The recently completed PARAGON-HF trial showed that sacubitril/valsartan modestly reduced the risks of total heart failure hospitalizations and cardiovascular death than valsartan in patients with HFpEF, although this finding narrowly missed statistical significance,[18] Clinical benefits were observed in secondary endpoints including quality of life and kidney endpoints; women and patients at the lower end of the LVEF spectrum appeared to preferentially benefit. The safety profile of sacubitril/valsartan was largely consistent with prior trial experiences. Regulatory review of sacubitril/valsartan for the treatment of HFpEF is currently under way. Ongoing trials are evaluating the clinical utility of sacubitril/valsartan among patients with HFpEF (PARALLAX) and acute myocardial infarction ... In the last 5 years, sacubitril/valsartan has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic HFrEF. The next 5 years should see its wider implementation in practice and potential expansion of its therapeutic indications"
  • Entresto Halves Renal Events in Preserved EF Heart Failure Patients - Medscape, 10/14/20 - "sacubitril/valsartan treatment, an angiotensin-receptor/neprilysin inhibitor (ARNI), cut the incidence of the combined renal endpoint — renal death, end-stage renal disease, or at least a 50% drop in estimated glomerular filtration rate (eGFR) ... Also notable was that renal protection from sacubitril/valsartan was equally robust across the range of baseline kidney function"
  • EMPEROR-Reduced: Empagliflozin's HFrEF Benefit Holds Steady on Top of Sacubitril/Valsartan - Medscape, 10/7/20 - "When there are two very effective treatments, it's common for people to ask: Which should I use?' The goal of my presentation was to emphasize that the answer is both. We shouldn't choose between neprilysin inhibition [sacubitril inhibits the enzyme neprilysin] and SGLT2 [sodium-glucose transporter 2] inhibition; we should use both"
  • In-hospital Start of Sacubitril-Valsartan - Medscape, 8/17/20 - "From a healthcare system perspective, initiation of sacubitril-valsartan during hospitalization saved $452 per year compared with continuing enalapril (Vasotec), and $811 per year compared with initiation at 2 months after hospitalization ...Compared with continuation of enalapril indefinitely, switching patients to sacubitril-valsartan during their HF admission was associated with a cost per quality-adjusted life-year (QALY) gained of $21,532 ... As modeled in this study, starting the drug during hospitalization was associated with 62 fewer HF-related admissions per 1000 patients compared with outpatient initiation at 2 months (similar to the PARADIGM-HF strategy) and 116 fewer HF-related admissions compared with continuation of enalapril treatment ... the researchers also saw a reduction in HF-related readmissions with sacubitril-valsartan compared with enalapril. Rehospitalization for HF, which was assessed as part of a composite clinical events endpoint, was reduced from 13.8% in the enalapril arm to 8% with sacubitril-valsartan"
  • Ejection Fraction in Heart Failure Revisited-Where Does the Evidence Start? - Medscape, 7/27/20 - "The authors observed a similar effect on treatment with sacubitril/valsartan as in placebo-controlled trials in the low EF group. Interestingly, at an EF of from 40% to <55%, a clear sign for risk reduction was also observed"
  • SAVE-ICD: For Some, Sacubitril/Valsartan May Obviate Need for ICD - Medscape, 7/3/20 - "After 6 months of therapy with the combination drug sacubitril/valsartan (S/V; Entresto, Novartis), one quarter of primary prevention patients with left heart failure and an implantable cardioverter defibrillator (ICD) had a left ventricular ejection fraction (LVEF) > 35% with no arrhythmic events"
  • HFpEF: Gender Difference in Sacubitril/Valsartan Response Remains Mystery - Medscape, 4/20/20 - "In women, however, who comprised more than half of the study population, the benefit of sacubitril/valsartan was larger: a 27% relative risk reduction compared to valsartan alone. That's a statistically significant difference in a prespecified subgroup analysis, but according to the rules of clinical trials and statistics it must be considered hypothesis-generating and nondefinitive, since the overall trial was negative. Men randomized to sacubitril/valsartan had a modest 3% increased risk of the primary endpoint compared to men on valsartan."
  • Tolerability and efficacy of Sacubitril/ Valsartan in clinical practice - Intern Med J. 2020 Jan 6 - "Heart failure is a major cause of morbidity and mortality. Sacubitril/Valsartan has demonstrated reductions in HF hospitalisation, and all-cause mortality in patients with heart failure with reduced ejection fraction (HFrEF) ... 14% of patients were able to able to achieve maximal dose (97/103 mg twice daily) whilst 37% remained on 49/51 mg and 23% on 24/26 mg. The mean SBP reduced from 118 ± 18 mmHg to 109 ± 15 mmHg with symptomatic hypotension (30%) being the most common side effect leading to dose reduction or drug cessation. Left ventricular ejection fraction (LVEF) improved from 29.1 ± 9.7% to 33.8 ± 9.9% (p < 0.05) on drug. There was also a significant improvement in quality of life scores; EQ5D-VAS 40 pre vs 67 post Sacubitril/Valsartan (p < 0.05), and New York Heart Association class (p < 0.05). Importantly, ten patients lost an existing indication for device based therapy after treatment with Sacubitril/Valsartan ... Sacubitril/Valsartan is a much needed therapeutic advancement in the treatment of HF. Our study indicates it is well tolerated with improvements in cardiac function and symptoms. Sacubitril/Valsartan could redefine the definition of "optimal medical therapy' when assessing patients for device based therapies"
  • Sacubitril/Valsartan Benefits Extend to HF With Mildly Reduced EF - Medscape, 11/17/19 - "Further analyses of the PARADIGM and PARAGON heart failure trials of sacubitril/valsartan (Entresto, Novartis) appear to show that the benefits of the drug combination established in patients with low ejection fraction (EF) appear to extend to patients with mildly reduced EF, and to a higher EF range in women than men ... When the results were examined according to baseline EF, women showed a benefit of sacubitril/valsartan across the range of EFs up to about 65%. But in men, the benefit was attenuated at around 55%"
  • Entresto Sales See Slow and Steady Upturn - Medscape, 10/25/19 - "Despite narrowly missing its primary end point of heart failure (HF) hospitalization or cardiac deaths among patients with HF and preserved ejection fraction in PARAGON-HF, subgroup analyses in patients with an ejection fraction up to 57% and women showed significant benefits"
  • PROVE-HF Cracks the 'Holy Grail' of Cardiac Remodeling in HFrEF - Medscape, 10/7/19 - 14 minute video on Entresto to improve for low ejection fraction. - "For the group as a whole, by 6 months we saw an average 5.2% increase in the EF, and by 1 year a 9.5% rise in the EF."
  • Is Sacubitril/Valsartan (Also) an Antiarrhythmic Drug? - Medscape, 10/8/18 - "No randomized ICD trials have been performed yet in patients receiving sacubitril/valsartan, but it is reasonable to assume that, as new therapies improve overall survival and reduce sudden death, the additional survival benefit provided by an ICD will become narrower. In this new era of HF management, we may need to reassess the role of ICDs in primary prevention for patients with HF in the context of angiotensin receptor neprilysin inhibitor therapy added to β-blockers and mineralocorticoid receptor antagonists, especially if evidence continues to suggest antiarrhythmic effects of sacubitril/valsartan"
  • Shock and Awe: Sacubitril/Valsartan for Severe HF Safely Started in ICU in Early Cases - Medscape, 9/17/19 - "When they left the ICU, on average they had a significant improvement"
  • Sex, Intimacy Improved on Sacubitril/Valsartan in Heart Failure - Medscape, 4/10/18 - "Improvements over 36 months were most pronounced in domains that reflected being able to work, do household chores or recreational activities, climb stairs, and have intimate and sexual relationships ... It's kind of saying these patients are feeling as if they are 9 years younger"
    • 10 Things to Know About New Heart Failure Med Entresto - goodrx.com - "Sacubitril is the newer half of Entresto. Bear with me for some details. Inhibiting neprilysin raises levels of several peptides (small proteins) that have beneficial effects on blood flow in patients with HF. Remember that low cardiac output (low blood flow because the heart can’t squeeze well) is the main problem in heart failure. Saccubitril, the neprilysin inhibitor in Entresto, improves blood flow to the kidneys and improves removal of fluid (diuresis), among other things."
    • Entresto: Are You Ready To Trade Heart Failure For Alzheimer’s? - The Daily Health, 11/16/16 - "One of the key ingredients in Entresto – known as sacubitril – prevents the enzyme that breaks down amyloid beta plaques from doing its job. If these amyloid beta plaques are not broken down properly they can accumulate in our brains and can cause dementia and Alzheimer’s ... So while Entresto promises to be a silver bullet for your heart, it could also be a bullet through your brain!"