Omapatrilat: clinical pharmacology.
Omapatrilat is the most clinically advanced member of a new class of cardiovascular agents known as vasopeptidase inhibitors. Omapatrilat acts by inhibiting two key enzymes responsible for blood pressure regulation: neutral endopeptidase and angiotensin-converting enzyme. Omapatrilat provides dose-related reductions in systolic and diastolic blood pressure with an excellent trough-to-peak ratio after once-daily administration. The reduction in blood pressure is proportional to baseline blood pressure. Used in monotherapy, omapatrilat controls hypertension in more than 65% of patients treated and reduces blood pressure to a greater extent than existing agents. Furthermore, omapatrilat exhibits an excellent tolerability profile. Therefore, this drug represents an important new approach for treating a wide range of patients, including those who are difficult to control, such as elderly patients with isolated systolic hypertension and patients with diabetes. The results of early clinical trials in patients with congestive heart failure have shown that omapatrilat not only improves symptoms but also reduces the risk of and hospitalization and death when compared with ACE inhibitors alone. These results indicate that vasopeptidase inhibition is a promising new strategy in the treatment of hypertension and cardiac diseases.
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Hypertension Unit, Hospital Clinic, Barcelona, Spain.