On 31 August, at this year’s European Society of Cardiology (ESC) conference, during a late-breaking science session on the topic of “Chronic Heart Failure,” Dr. Atsushi Tanaka, presented the findings of the Premier study. Tanaka focused on angiotensin-neprilysin inhibition to highlight the progress made in the management of acute heart failure (HF).
The findings presented at ESC showed that the use of sacubitril/valsartan (Sac/Val) on top of existing recommended HF therapies prompted a greater N-terminal pro-brain natriuretic peptide reduction in Japanese patients hospitalised for acute HF, without increased risk of adverse events. Tanaka emphasised that findings could expand the evidence with regards to Sac/Val use in this clinical setting outside North America.
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Key opinion leaders (KOLs) interviewed by GlobalData have emphasised that if a patient is hospitalised for HF, they will be given Sac/Val, and if they are on an angiotensin-converting-enzyme inhibitor or angiotensin receptor blockers, they are switched to Sac/Val in the hospital.
Sac/Val was seen as a revolutionary advancement in the HF field due to its demonstrated efficacy in the Phase III PARADIGM-HF trial in reducing the number of deaths due to cardiovascular causes, HF hospitalisations, and all-cause mortality compared to angiotensin-converting enzyme inhibitors.
Sac/Val was launched in the US in July 2015, under brand name Entresto and subsequently launched across the five major European markets (5EU: France, Germany, Italy, Spain, and UK) in 2016. Valsartan blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II by selectively blocking the binding of angiotensin II to the AT1 receptor in many tissues. Sacubitril is an inhibitor of neutral endopeptidase.
Many patients who present with acute HF either have a history of HF or have advanced HF that has suddenly decompensated. However, a proportion of acute HF hospitalisations are referred to as a de novo acute HF episode—patients with no prior history of HF. Although it is easier to identify acute HF in a patient previously diagnosed with HF, it is still vital to determine the cause of the sudden decompensation of HF, as well as the severity of their condition. Incidence of acute HF represents a huge financial burden on the global healthcare systems due to the resources and costs associated with hospitalisation and the highly likely readmission of a patient. Therefore, developing an evidence-based therapy for the treatment of acute HF represents a huge opportunity.
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