A review of vasopeptidase inhibitors: a new modality in the treatment of hypertension and chronic heart failure.
Vasopeptidase inhibitors are a group of agents capable of inhibiting neutral endopeptidase and angiotensin-converting enzymes, which leads to potentiation of natriuretic peptide actions and suppression of the renin-angiotensin-aldosterone system. With this distinctively characteristic mechanism, these agents have emerged as a new drug class for management of hypertension and heart failure. Several vasopeptidase inhibitors are under clinical investigation. Omapatrilat is the most studied agent in this class. Clinical studies of omapatrilat in hypertension have consistently shown the agent's effectiveness in a variety of patient populations. In patients with heart failure, omapatrilat significantly improved neurohormonal and hemodynamic status. Long-term effects of omapatrilat in patients with heart failure recently were compared with those of conventional therapy in a large phase II trial. Results of the study appear promising. Large clinical trials are ongoing, and additional information regarding safety and efficacy from these studies may help define the place in therapy for this agent.
Nathisuwan
Surakit
S
College of Pharmacy, The University of Texas at Austin, USA.
Talbert
Robert L
RL
D017311:Amlodipine / Q000008:administration & dosage / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000818:Animals; D009320:Atrial Natriuretic Factor / Q000097:blood; D004305:Dose-Response Relationship, Drug; D006333:Heart Failure / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy*; D017706:Lisinopril / Q000008:administration & dosage / Q000627:therapeutic use; D008698:Mesylates / Q000008:administration & dosage / Q000627:therapeutic use; D020097:Natriuretic Peptide, Brain / Q000097:blood; D015260:Neprilysin / Q000037:antagonists & inhibitors*; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013841:Thiazepines / Q000008:administration & dosage / Q000627:therapeutic use*; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000806:Angiotensin-Converting Enzyme Inhibitors; D008698:Mesylates; D011725:Pyridines; D013841:Thiazepines; D020097:Natriuretic Peptide, Brain; D017311:Amlodipine; C106266:omapatrilat; D014443:Tyrosine; D009320:Atrial Natriuretic Factor; D017706:Lisinopril; D015260:Neprilysin; C111998:sampatrilat