Study: Investigational drug may change course of patients’ heart failure

Dr Anand

Investigational drug LCZ696 (Novartis), an angiotensin receptor neprilysin inhibitor (ARNI), is superior to an angiotensin-converting enzyme (ACE) inhibitor alone in reducing the risks of death and of hospitalization for heart failure, according to data presented at the American Heart Association's (AHA) Scientific Sessions in Chicago.

The data was published simultaneously in Circulation.

Called a "game-changing” study by some industry insiders, PARADIGM-HF was a double-blind randomized active treatment comparison of LCZ696 versus enalapril in target doses in high-risk patients with heart failure with reduced ejection fraction (HFrEF).

Then study showed that in patients with HFrEF, as compared to the standard of care recommended target doses of the ACE inhibitor enalapril, LCZ696 reduced all-cause mortality by 16%, cardiovascular mortality by 20%, and first and recurrent hospitalizations for heart failure 21% and 23%, respectively.

“In addition, the drug improved the patient’s quality of life [QoL],” said Inder Anand, MD, FACC, Minneapolis VA Medical Center & Minnesota University. 

“Further analyses of the PARADIGM-HF database just presented at AHA indicate that use of LCZ696 was also associated with a significant reductions in sudden deaths, emergency room visits and need for more intense treatment compared with enalapril,” Dr Anand said.

“The findings of this study will ultimately change the way we treat patients with HF, with the introduction of LCZ696 as the first line of therapy instead of enalapril or another ACE inhibitor,” he said. “It might, however, take some years before the guidelines will change and the managed care and hospital providers agree to pay for the drug. Rapid publication of economic analyses will certainly help to hasten this process.”