A new word in the treatment of chronic heart failure

The drug consists of two active substances. One of them - valsartan - is well known to every practitioner. The second component, sakubitryl, is first introduced into clinical practice. To understand the pharmacodynamics of this drug, one must have an idea of ​​the function of the enzyme neprilizin. Normally, non-lysis promotes the degradation of a number of vasoactive substances (bradykinin, brain natriuretic peptide, etc.), whose activity reduces the burden on the heart. Sacubitryl inhibits the function of non-lysine, which leads to the accumulation of the aforementioned substances and the prolongation of their positive effects (see the scheme below).

The clinical efficacy of sacubilitrile / valsartan was shown in the PARADIGM-HF study, during which the drug was compared with the classic ACE inhibitor enalapril. Scientific work was carried out on the basis of 1043 clinical centers in 47 countries.The total number of patients is 10 521 people. After 27 months, the study was prematurely discontinued due to the stunning advantage of the combination of sacubilitrile / valsartan.

Nevertheless, the average annual cost of treatment is very high (~ $ 4,500), therefore saccitrile / valsartan is certainly a reserve preparation for patients who can not be controlled by standard therapy with symptomatic chronic heart failure (see algorithm).