Results of a single center experience on 110 consecutive patients treated with Entresto (sacubitril/valsartan)

Canu, Antonella; Hebert, M.; Gachet, A.; Arabucki, Fabien; Maurin, V.; Picard, Frauke; Santos, Pierre Dos

doi:10.1016/s1878-6480(17)30123-4

Cited by 6 publications

(5 citation statements)

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“…Patients who were up‐titrated on sac/val tended to be prescribed lower daily diuretic doses post‐index than those who were down‐titrated on sac/val. This has been reported in other observational cohorts, and may suggest a small diuretic effect of sac/val or reflect the reduction in HF symptoms by sac/val, which allows a lowering of diuretic dose. Additionally, an analysis of the PARADIGM‐HF study cohort also indicated that patients receiving sac/val were more likely to experience a diuretic dose reduction than patients receiving enalapril .…”

Section: Discussionsupporting

confidence: 74%

Real‐world treatment patterns of sacubitril/valsartan: a longitudinal cohort study in Germany

Wachter

Fonseca

Balas

et al. 2019

European J of Heart Fail

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Aims To analyse real‐world treatment patterns of sacubitril/valsartan (sac/val) using data from a pharmacy database in Germany. Methods and results A retrospective cohort study of 26 191 adult patients (aged ≥ 18 years) in the IMS® longitudinal prescriptions database in Germany who were dispensed sac/val from January 2016 to June 2017 was conducted. The analysis included sac/val dose titration assessed in the 6 months from first sac/val prescription; prescriptions of concomitant cardiovascular medications in the 6 months pre‐ and post‐index and compliance and persistence during 12 months post‐index. Two‐thirds of patients were prescribed the lowest sac/val dose of 50 mg twice daily (b.i.d.) at index and up‐titration during the first 6 months was attempted in 41% of these patients. Ten percent of patients prescribed 200 mg b.i.d. at index had to be stably down‐titrated; among patients prescribed 50 or 100 mg b.i.d. at index that were up‐titrated, > 80% remained on the higher dose. Overall, the mean daily diuretic dose decreased by 25% after initiation of sac/val. High compliance and persistence rates were observed across sac/val doses, increasing with higher sac/val dose at index. Prior dose of angiotensin‐converting enzyme inhibitor or angiotensin receptor blocker had only minor impact on first sac/val dose, compliance and persistence. Conclusions Most patients prescribed sac/val are not initiated on the recommended dose nor up‐titrated as recommended by the EU Summary of Product Characteristics. Initiation of sac/val was associated with high persistence and compliance and a dose reduction of diuretics. Barriers to up‐titration must be explored.

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Section: Discussionsupporting

confidence: 74%

Real‐world treatment patterns of sacubitril/valsartan: a longitudinal cohort study in Germany

Wachter

Fonseca

Balas

et al. 2019

European J of Heart Fail

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“…Apart from hospitalisations and mortality outcomes, many studies assessed changes in NYHA functional class (n = 25) and NT-proBNP levels (n = 21) before and after initiation of sac/val. A significant improvement in NYHA functional class was observed in 12 studies [14,17,21,22,[25][26][27][28][29][30][31][32]. Fig.…”

Section: Clinical Effectiveness Outcomesmentioning

confidence: 99%

“…In most studies, patients were initiated at a low dose of sac/val (24/ 26 mg) and may then have been up-titrated. Seven out of 29 studies reported that > 50% of total patients achieved the target dose over the follow-up period [26,33,36,[38][39][40][41] (Supplementary Fig. 3 and Table 4).…”

Section: Safety and Tolerabilitymentioning

confidence: 99%

Real-world effectiveness and safety of sacubitril/valsartan in heart failure: A systematic review

Proudfoot

Studer

Rajput

et al. 2021

International Journal of Cardiology

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Background: PARADIGM-HF demonstrated superiority of sacubitril/valsartan (sac/val) over enalapril in patients with heart failure with reduced ejection fraction (HFrEF). However, patients in clinical practice may differ in their characteristics and overall risk compared with patients in clinical trials, and additional outcomes can be observed in real world (RW). Hence, a systematic review was conducted to identify and describe RW data on sac/val. Methods: RW studies evaluating the effects of sac/val in adult patients with HFrEF with a sample size ≥100 were identified via MEDLINE® and Embase® from 2015 to January 2020. Citations were screened, critically appraised and relevant data were extracted. Results: A total of 68 unique studies were identified. Nearly half of the studies were conducted in Europe (n = 34), followed by the US (n = 15) and Asia (n = 11). Median follow-up period varied from 1 to 19 months. Mean age ranged between 48.7 and 79.0 years; patients were mostly male and in New York Heart Association (NYHA) functional class II/III, and mean left ventricular ejection fraction varied between 23%and 38%. Of studies performing comparisons, most reported superior efficacy of sac/val in reducing the risk of HF hospitalisations, allcause hospitalisations, and all-cause mortality as compared to standard-of-care. Many studies reported significant improvements in NYHA functional class and reduction in biomarker levels post sac/val. Hypotension and hyperkalaemia were the most frequently reported adverse events. Conclusions: This comprehensive overview of currently available RW evidence on sac/val complements the evidence from randomised controlled trials, substantiating its effectiveness in heterogeneous real-world HF populations.

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“…In the PARADIGM-HF trial, at 8 months, patients in the sacubitril/valsartan arm had a lower rate of worsening NYHA class compared to enalapril (5.4% vs 7.0%; p ¼ 0.004) 9 . This finding is also applicable to the real world setting, as the treatment with sacubitril/valsartan has been shown to lead to an improvement in NYHA class 10 . Applying utility values by NYHA class and assuming the same transition probabilities will under-estimate the benefits of sacubitril/valsartan.…”

Section: Re: Cost-effectiveness Of Sacubitril/valsartan Versus Enalapril In Patients With Heart Failure and Reduced Ejection Fractionmentioning

confidence: 69%

RE: Cost-effectiveness of sacubitril/valsartan versus enalapril in patients with heart failure and reduced ejection fraction

Cristino

Tang

et al. 2018

Journal of Medical Economics

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Results of a single center experience on 110 consecutive patients treated with Entresto (sacubitril/valsartan)

Cited by 6 publications

References 0 publications

Real‐world treatment patterns of sacubitril/valsartan: a longitudinal cohort study in Germany

Real‐world treatment patterns of sacubitril/valsartan: a longitudinal cohort study in Germany

Real-world effectiveness and safety of sacubitril/valsartan in heart failure: A systematic review

RE: Cost-effectiveness of sacubitril/valsartan versus enalapril in patients with heart failure and reduced ejection fraction

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