Neprilysin Inhibitors: Emerging Therapy for Heart Failure.
Biologically active natriuretic peptides (NPs) are an integral part of cardiac homeostasis as they help to maintain sodium and fluid balance. When homeostasis is perturbed by neurohormonal activation in heart failure, levels of NPs rise in response. Neprilysin (NEP) is a naturally occuring enzyme that breaks down NPs. Scientists have recently discovered a novel pharmacologic agent that combines a NEP inhibitor and an angiotensin receptor blocker. In a large clinical trial, this new drug was found to reduce hospitalization and mortality in systolic heart failure. The challenges of implementing this therapy include patient selection, cost, and risk of side effects including angioedema and Alzheimer's disease.
Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; email: anjali.owens@uphs.upenn.edu , susan.brozena@uphs.upenn.edu , mariell.jessup@uphs.upenn.edu.
Anjali Tiku
AT
Owens
Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; email: anjali.owens@uphs.upenn.edu , susan.brozena@uphs.upenn.edu , mariell.jessup@uphs.upenn.edu.
Susan
S
Brozena
Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104; email: anjali.owens@uphs.upenn.edu , susan.brozena@uphs.upenn.edu , mariell.jessup@uphs.upenn.edu.
Mariell
M
Jessup
D000544:Alzheimer Disease / Q000139:chemically induced; D000613:Aminobutyrates / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D000799:Angioedema / Q000139:chemically induced; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects; D001713:Biphenyl Compounds; D004338:Drug Combinations; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015260:Neprilysin / Q000037:antagonists & inhibitors* / Q000378:metabolism; D018579:Patient Selection; D011725:Pyridines / Q000009:adverse effects; D013318:Stroke Volume; D013777:Tetrazoles / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D013841:Thiazepines / Q000009:adverse effects; D000068756:Valsartan
D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001713:Biphenyl Compounds; D004338:Drug Combinations; D011725:Pyridines; D013777:Tetrazoles; D013841:Thiazepines; C106266:omapatrilat; D000068756:Valsartan; D015260:Neprilysin; C549068:sacubitril and valsartan sodium hydrate drug combination
LCZ696; angiotensin receptor antagonist and neprilysin inhibitor (ARNI); angiotensin receptor antagonists; angiotensin-converting enzyme (ACE) inhibitors; heart failure; sacubitril; valsartan