title: Focus on the Novel Cardiovascular Drug LZC696: from Evidence to Clinical Consideration.
abstract: LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor (ARNI), is comprised of the angiotensin receptor blocker valsartan and the neprilysin inhibitor pro-drug sacubitril (AHU377). After oral administration, AHU377 is rapidly metabolized to the active neprilysin inhibitor LBQ657. LCZ696 exerts its effects of diuresis, natriuresis, vasodilation and aldosterone secretion inhibition through simultaneous renin-angiotensin-aldosterone system (RAAS) blockade and natriuretic peptides system (NPS) enhancement. Powerful evidence including PARAMETER and PRARDIGM-HF trials have shown that LCZ696 outperforms RAAS inhibition in treating patients with hypertension and heart failure with reduced ejection fraction (HFrEF), and is well tolerated. In addition, accumulating evidence also suggests its potential use in heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD), post-myocardium infarction (post-MI) and stroke. Both the FDA and CHMP have approved LCZ696 for treatment of HFrEF. Despite all this, some special issues (e.g. use in specific subgroups, adverse events, contraindications and cost-effectiveness analysis) should be considered before its implementation in clinical practice.
authors.affiliation: Department of Cardiology, Affiliated Hospital of Putian University, Putian, Fujian, China. 2533358160@qq.com.
authors.forename: L M
authors.initials: LM
authors.lastname: Lin
authors.affiliation: Department of Cardiology, Affiliated Hospital of Putian University, Putian, Fujian, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Cardiology, Affiliated Hospital of Putian University, Putian, Fujian, China.
authors.forename: M F
authors.initials: MF
authors.lastname: Wu
authors.affiliation: Department of Cardiology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
authors.forename: J X
authors.initials: JX
authors.lastname: Lin
mesh_terms: D000613:Aminobutyrates / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000818:Animals; D001713:Biphenyl Compounds; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000075202:Contraindications; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D006333:Heart Failure / Q000188:drug therapy; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D009203:Myocardial Infarction / Q000188:drug therapy; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy; D013777:Tetrazoles / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds; D002317:Cardiovascular Agents; D004338:Drug Combinations; D013777:Tetrazoles; D000068756:Valsartan; C549068:sacubitril and valsartan sodium hydrate drug combination
keywords: Angiotensin receptor neprilysin inhibitor; Heart failure; Hypertension; LCZ696; Sacubitril/valsartan