Sacubitril/valsartan continues to demonstrate its value in managing acute heart failure (HF), according to findings from the PREMIER study presented at the European Society of Cardiology (ESC) conference. The research, led by Dr. Atsushi Tanaka, focused on angiotensin-neprilysin inhibition and its impact on patients hospitalized for acute HF.
PREMIER Study Details
The PREMIER study investigated the effects of sacubitril/valsartan in Japanese patients hospitalized with acute HF. The results indicated that adding sacubitril/valsartan to existing recommended HF therapies led to a greater reduction in N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, a key marker of heart failure severity. Importantly, this benefit was observed without an increased risk of adverse events.
Clinical Implications
Dr. Tanaka emphasized that these findings broaden the evidence base for sacubitril/valsartan use in acute HF management, particularly outside of North America. Key opinion leaders (KOLs) interviewed by GlobalData have noted a trend toward using sacubitril/valsartan in hospitalized HF patients, often switching them from angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs).
Sacubitril/Valsartan Mechanism and Background
Sacubitril/valsartan, marketed as Entresto, was first launched in the US in July 2015 and subsequently in Europe in 2016. The drug combines valsartan, which blocks the angiotensin II receptor (AT1), and sacubitril, an inhibitor of neutral endopeptidase. This dual mechanism helps to reduce vasoconstriction and promote natriuresis, offering significant benefits in HF management.
The Phase III PARADIGM-HF trial previously demonstrated sacubitril/valsartan's efficacy in reducing cardiovascular deaths, HF hospitalizations, and all-cause mortality compared to ACE inhibitors, establishing it as a revolutionary advancement in the field.
The Burden of Acute Heart Failure
Acute HF poses a substantial financial burden on global healthcare systems due to hospitalization costs and high readmission rates. Many patients presenting with acute HF have either a history of the condition or have experienced a sudden decompensation of advanced HF. A portion of these hospitalizations are due to de novo acute HF episodes in patients with no prior HF history. Identifying the cause and severity of acute HF is crucial for effective management.
Developing evidence-based therapies like sacubitril/valsartan is essential for improving outcomes and reducing the economic impact of acute HF. The PREMIER study adds further support to its use in this critical clinical setting.
