Candoxatril improves exercise capacity in patients with chronic heart failure receiving angiotensin converting enzyme inhibition.
OBJECTIVE
To assess the effect of candoxatril, a novel neutral endopeptidase inhibitor, on exercise capacity, clinical status and quality of life in patients with mild to moderate chronic heart failure receiving angiotensin converting enzyme inhibition.


RESULTS
Patients were recruited from 16 centres throughout the United Kingdom. Following a 4-week single-blind placebo 'run-in' phase of weekly exercise tests, patients underwent double-blind randomization to receive either candoxatril (100 mg twice daily) or placebo for the next 84 days. Patients were then reassessed every 28 days. Of 110 patients randomized, 56 received candoxatril and 54 placebo. Over the study period, the overall improvement in mean total exercise time in the candoxatril group in comparison to the placebo group was 34.1 s (P=0.02: 95% confidence interval: 5.1 to 63.0). There were no significant changes in functional class, clinical status or quality of life scores between the two groups. There was a trend for a small reduction in blood pressure in the candoxatril group.


CONCLUSIONS
Candoxatril confers an improvement in exercise capacity in patients with chronic heart failure who are receiving maintenance angiotensin converting enzyme inhibitor therapy.
Newby
D E
DE
Department of Cardiology, Royal Infirmary, Edinburgh, Scotland, UK.
McDonagh
T
T
Currie
P F
PF
Northridge
D B
DB
Boon
N A
NA
Dargie
H J
HJ
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007189:Indans / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000037:antagonists & inhibitors; D011422:Propionates / Q000627:therapeutic use*; D011480:Protease Inhibitors / Q000627:therapeutic use*; D013997:Time Factors
D000806:Angiotensin-Converting Enzyme Inhibitors; D007189:Indans; D011422:Propionates; D011480:Protease Inhibitors; C062766:candoxatril; D015260:Neprilysin