1,214
Views
17
CrossRef citations to date
0
Altmetric
Drug Profile

Sacubitril/valsartan (LCZ696) for the treatment of heart failure

&
Pages 145-153 | Received 23 Oct 2015, Accepted 03 Dec 2015, Published online: 08 Jan 2016

References

  • Papers of special note have been highlighted as:
  • • of interest
  • •• of considerable interest
  • Curtis LH, Whellan DJ, Hammill BG, et al. Incidence and prevalence of heart failure in elderly persons, 1994–2003. Arch Intern Med. 2008;168:418–424.
  • Mozaffarian D, Benjamin EJ, Go AS, et al. American Heart Association Statistics Committee And Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2015 update: a report from the American Heart Association. Circulation. 2015 Jan 27;131(4):e29–322.
  • Roger VL, Weston SA, Redfield MM, et al. Trends in heart failure incidence and survival in a community-based population. JAMA. 2004;292:344–350.
  • Levy D, Kenchaiah S, Larson MG, et al. Long-term trends in the incidence of and survival with heart failure. N Engl J Med. 2002;347:1397–1402.
  • Yancy CW, Jessup M, Bozkurt B, et al. American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013 Oct 15;62(16):e147–239.
  • McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Committee for Practice Guidelines. ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2012 Aug;14(8):803–869.
  • Roger VL. Epidemiology of heart failure. Circ Res. 2013;113:646–659.
  • Steinberg BA, Zhao X, Heidenreich PA, et al. Trends in patients hospitalized with heart failure and preserved left ventricular ejection fraction: prevalence, therapies, and outcomes. Circulation. 2012;126:65–75.
  • Komajda M, Lam CS. Heart failure with preserved ejection fraction: a clinical dilemma. Eur Heart J. 2014;35:1022–1032.
  • Gori M, Senni M, Gupta DK, et al. PARAMOUNT Investigators. Association between renal function and cardiovascular structure and function in heart failure with preserved ejection fraction. Eur Heart J. 2014 Dec 21;35(48):3442–3451.
  • Cohn JN, Johnson G, Ziesche S, et al. A comparison of enalapril with hydralazine-isosorbide dinitrate in the treatment of chronic congestive heart failure. N Engl J Med. 1991 Aug 1;325(5):303–310.
  • Granger CB, McMurray JJ, Yusuf S, et al. CHARM Investigators and Committees. Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet. 2003 Sep 6;362(9386):772–776.
  • von Lueder TG, Sangaralingham SJ, Wang BH, et al. Renin angiotensin blockade combined with natriuretic peptide system augmentation: novel therapeutic concepts to combat heart failure. Circ Heart Fail. 2013;6:594–605.
  • Vanneste Y, Michel A, Dimaline R, et al. Hydrolysis of alpha-human atrial natriuretic peptide in vitro by human kidney membranes and purified endopeptidase-24.11. Evidence for a novel cleavage site. Biochem J. 1988;254:531–537.
  • Norman JA, Little D, Bolgar M, et al. Degradation of brain natriuretic peptide by neutral endopeptidase: species specific sites of proteolysis determined by mass spectrometry. Biochem Biophys Res Commun. 1991;175:22–30.
  • Lang CC, Motwani JG, Coutie WJ, et al. Clearance of brain natriuretic peptide in patients with chronic heart failure: indirect evidence for a neutral endopeptidase mechanism but against an atrial natriuretic peptide clearance receptor mechanism. Clin Sci (Lond). 1992;82:619–623.
  • Abassi ZA, Golomb E, Agbaria R, et al. Hydrolysis of iodine labelled urodilatin and ANP by recombinant neutral endopeptidase EC. 3.4.24.11. Br J Pharmacol. 1994;113:204–208.
  • Cruden NL, Witherow FN, Webb DJ, et al. Bradykinin contributes to the systemic hemodynamic effects of chronic angiotensin-converting enzyme inhibition in patients with heart failure. Arterioscler Thromb Vasc Biol. 2004;24:1043–1048.
  • Dalzell JR, Seed A, Berry C, et al. Effects of neutral endopeptidase (neprilysin) inhibition on the response to other vasoactive peptides in small human resistance arteries: studies with thiorphan and omapatrilat. Cardiovasc Ther. 2014;32:13–18.

• Study describing some of the vasoactive substances metabolized by neprilysin.

  • Wilkinson IB, McEniery CM, Bongaerts KH, et al. Adrenomedullin (ADM) in the human forearm vascular bed: effect of neutral endopeptidase inhibition and comparison with proadrenomedullin NH2-terminal 20 peptide (PAMP). Br J Clin Pharmacol. 2001;52:159–164.
  • Matsas R, Rattray M, Kenny AJ, et al. The metabolism of neuropeptides. Endopeptidase-24.11 in human synaptic membrane preparations hydrolyses substance P. Biochem J. 1985;228:487–492.
  • Katayama M, Nadel JA, Bunnett NW, et al. Catabolism of calcitonin gene-related peptide and substance P by neutral endopeptidase. Peptides. 1991;12:563–567.
  • McDowell G, Coutie W, Shaw C, et al. The effect of the neutral endopeptidase inhibitor drug, candoxatril, on circulating levels of two of the most potent vasoactive peptides. Br J Clin Pharmacol. 1997;43:329–332.
  • Fryer RM, Segreti J, Banfor PN, et al. Effect of bradykinin metabolism inhibitors on evoked hypotension in rats: rank efficacy of enzymes associated with bradykinin-mediated angioedema. Br J Pharmacol. 2008 Mar;153(5):947–955.
  • Webb RL, Ksander GM. Pharmaceutical compositions comprising valsartan and NEP inhibitors. International Patent Application PCT/ EP03/00415. 2003.
  • Feng L, Karpinski PH, Sutton P, et al. LCZ696: a dual-acting sodium supramolecular complex. Tetrahedron Lett. 2012;53:275–276.
  • Gu J, Noe A, Chandra P, et al. Pharmacokinetics and pharmacodynamics of LCZ696, a novel dual-acting angiotensin receptor-neprilysin inhibitor. (ARNi). J Clin Pharmacol. 2010;50:401–414.

•• Study describing pharmacokinetics and pharmacodynamics properties of LCZ696.

  • Entresto Prescribing Information. [cited 2015 Jul 7]. Available from: http://www.pharma.us.novartis.com/product/pi/pdf/entresto.pdf.
  • Ando S, Rahman MA, Butler GC, et al. Comparison of candoxatril and atrial natriuretic factor in healthy men. Effects on hemodynamics, sympathetic activity, heart rate variability, and endothelin. Hypertension. 1995;26:1160–1166.
  • Cleland JG, Swedberg K, for the International Ecadotril Multi-Centre Dose-Ranging Study Investigators. Lack of efficacy of neutral endopeptidase inhibitor ecadotril in heart failure. Lancet. 1998;351:1657–1658.
  • Solomon SD, Zile M, Pieske B, et al. The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a Phase 2 double-blind randomised controlled trial. Lancet. 2012;380:1387–1395.

• PARAMOUNT trial: possible benefits of LCZ696 in HFpEF (surrogate end points).

  • McMurray J, Packer M, Desai A, et al. PARADIGM-HF Committees and Investigators. A putative placebo analysis of the effects of LCZ696 on clinical outcomes in heart failure. Eur Heart J. 2015 Feb 14;36(7):434–439.
  • Senni M, Reyes A, Majercak I, et al. Results of the TITRATION study: a 12-week, multicenter, randomized, double-blind, safety evaluation of a 3- versus 6-week up-titration regimen of LCZ696 in patients with HFrEF. Eur J Heart Fail Abstracts Supplement. 2015; 17(Supplement 1): 393.
  • Jhund PS, Claggett B, Packer M, et al. Independence of the blood pressure lowering effect and efficacy of the angiotensin receptor neprilysin inhibitor, LCZ696, in patients with heart failure with preserved ejection fraction: an analysis of the PARAMOUNT trial. Eur J Heart Fail. 2014 Jun;16(6):671–677.
  • Voors AA, Gori M, Liu LC, et al., for the PARAMOUNT Investigators. Renal effects of the angiotensin receptor neprilysin inhibitor LCZ696 in patients with heart failure and preserved ejection fraction. Eur J Heart Fail. 2015 May;17(5):510–517.

• Study regarding the renal effects of LCZ696.

  • Jhund PS, Claggett BL, Voors AA, et al.; PARAMOUNT Investigators. Elevation in high-sensitivity troponin T in heart failure and preserved ejection fraction and influence of treatment with the angiotensin receptor neprilysin inhibitor LCZ696. Circ Heart Fail. 2014 Nov;7(6):953–959.
  • McMurray JJ, Packer M, Desai AS, et al. Investigators P-H, Committees. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371:993–1004.

•• PARADIGM-HF trial: improved cardiovascular outcomes with LCZ696 as compared to ACE-inhibition in HFrEF.

  • McMurray JJ, Packer M, Desai AS, et al. Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF). Eur J Heart Fail. 2013;15:1062–1073.
  • McMurray JJ, Packer M, Desai AS, et al. Baseline characteristics and treatment of patients in Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF). Eur J Heart Fail. 2014;16:817–825.
  • Packer M, McMurray JJV, Desai AS, et al., for the PARADIGM-HF Investigators and Coordinators. Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure. Circulation. 2015;131:54–61.
  • Desai AS, McMurray JJ, Packer M, et al. Effect of the angiotensin-receptor-neprilysin inhibitor LCZ696 compared with enalapril on mode of death in heart failure patients. Eur Heart J. 2015 Aug 7;36(30):1990–1997.

• PARADIGM-HF subanalysis describing mode of death according to treatment allocation.

  • Simpson J, Jhund PS, Silva Cardoso J, et al. Comparing LCZ696 with enalapril according to baseline risk using the MAGGIC and EMPHASIS-HF risk scores: an analysis of mortality and morbidity in PARADIGM-HF. J Am Coll Cardiol. 2015 Nov 10;66(19):2059–2071.
  • Jhund PS, Fu M, Bayram E, et al; PARADIGM-HF Investigators and Committees. Efficacy and safety of LCZ696 (sacubitril-valsartan) according to age: insights from PARADIGM-HF. Eur Heart J. 2015 Jul 31. pii: ehv330. [Epub ahead of print]
  • Bohm M, Refsgaard J, Ramires FJA, et al. Effect of the angiotensin receptor neprilysin inhibitor LCZ696 compared with enalapril according to systolic blood pressure in PARADIGM-HF. Eur J Heart Fail Abstracts Supplement. 2015;17(Supplement 1):393.
  • Kristensen S, Squire I, Starling RC, et al. Risk related to diabetes and pre-diabetes in heart failure with reduced ejection fraction: insights from PARADIGM-HF. Eur Heart J. 2015;36(Abstract Supplement):875–876.
  • Vardeny O, Claggett B, McMurray JJV, et al. Efficacy of LCZ696 persists at lower than target doses in the PARADIGM-HF. Trial J Card Fail. 2015;21:S9–S10.
  • Zile M, McMurray JJV, Packer M, et al. Prognostic implications of achieving an N-terminal pro-B-type natriuretic peptide level <1000 pg/ml in patients with heart failure: data from PARADIGM-HF. J Card Fail. 2015;21(8):S106–S107.
  • Chen F, Charney A, Gong J, et al. Comparison of the baseline demographics of the LCZ696 PARADIGM-HF and TITRATION studies. J Card Fail. 2015;21(8):S45.
  • Vodovar N, Paquet C, Mebazaa A, et al. Neprilysin, cardiovascular, and Alzheimer’s diseases: the therapeutic split? Eur Heart J. 2015;36:902–905.
  • Cannon J, Boytsov S, Senni M, et al. Dementia-related adverse effects in the prospective comparison of ARNI with ACEI to determine impact on global mortality and morbidity in heart failure trial (PARADIGM-HF). Eur J Heart Fail Abstracts Supplement. 2015;17(Supplement 1):49.
  • Ruggenenti P, Remuzzi G. Combined neprilysin and RAS inhibition for the failing heart: straining the kidney to help the heart? Eur J Heart Fail. 2015 May;17(5):468–471.
  • Damman K, Andersen K, Belohlavek J, et al. Angiotensin receptor neprilysin inhibition and renal function in heart failure: results from PARADIGM-HF. Eur Heart J. 2015;36(Abstract Supplement):545.
  • Gori M, Senni M, Claggett B, et al. Effect of LCZ696 on urinary albumin excretion and relation to outcomes in patients with heart failure. Eur Heart J. 2015;36(Abstract Supplement):545.
  • Moe GW, Ezekowitz JA, O’Meara E, et al; Canadian Cardiovascular Society. The 2014 Canadian Cardiovascular Society Heart Failure Management Guidelines focus update: anemia, biomarkers, and recent therapeutic trial implications. Can J Cardiol. 2015 Jan;31(1):3–16.

• First published guidelines including recommendations regarding LCZ696 therapy in HF.

  • The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure: results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316:1429–1435.
  • Senni M, Gavazzi A, Gheorghiade M, et al. Heart failure at the crossroads: moving beyond blaming stakeholders to targeting the heart. Eur J Heart Fail. 2015 Aug;17(8):760–763.

•• Review emphasizing novel targets for HF therapy.

  • Jhund PS, Claggett BL, Voors AA, et al.;PARAMOUNT Investigators. Elevation in high-sensitivity troponin T in heart failure and preserved ejection fraction and influence of treatment with the angiotensin receptor neprilysin inhibitor LCZ696. Circ Heart Fail. 2014 Nov;7(6):953–959.
  • Jhund PS, Fu M, Bayram E, et al. Efficacy and safety of LCZ696 (sacubitril-valsartan) according to age: insights from PARADIGM-HF. Eur Heart J. 2015 Oct 7;36(38):2576–2584.
  • Ruilope LM, Dukat A, Bohm M, et al. Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study. Lancet. 2010;375:1255–1266.
  • Kario K, Sun N, Chiang FT, et al. Efficacy and safety of LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, in Asian patients with hypertension: a randomized, double-blind, placebo-controlled study. Hypertension. 2014;63:698–705.
  • Solomon SD, Packer M, Zile M, et al. The angiotensin receptor neprilysin inhibitor LCZ696 is effective across the spectrum of ejection fraction in heart failure with reduced ejection fraction. J Card Fail. 2015;21(8):S45–S46.
  • Shah AM, Claggett B, Sweitzer NK, et al. Prognostic importance of changes in cardiac structure and function in heart failure with preserved ejection fraction and the impact of spironolactone. Circ Heart Fail. 2015 Nov;8(6):1052–1058.

• Study showing mortality benefits of decreasing left atrial size in HFpEF.

  • von Lueder TG, Wang BH, Kompa AR, et al. Angiotensin receptor neprilysin inhibitor LCZ696 attenuates cardiac remodeling and dysfunction after myocardial infarction by reducing cardiac fibrosis and hypertrophy. Circ Heart Fail. 2015 Jan;8(1):71–78.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.