Entresto may prevent death in some heart failure patients

Timely and broad adoption of angiotensin receptor neprilysin inhibitor (ARNI)-Entresto (sacubitril/valsartan)-by all eligible heart failure patients with reduced ejection fraction (HFrEF) could prevent or postpone more than 28,000 deaths each year, in the U.S. alone, according to new analysis published in JAMA Cardiology.

This analysis, based on an application of the results of PARADIGM-HF to published heart failure statistics, is the first to quantify the possible impact of Entresto’s potential benefit in reducing death for heart failure patients with reduced ejection fraction (HFrEF). 

Fonarow

One of the most significant findings from the analysis is that as many as 28,484 deaths in HFrEF patients annually could be prevented or postponed with optimal use of ARNI therapy, according to lead author Gregg C. Fonarow, MD, FACC, FAHA, FHFSA, The Ahmanson-UCLA (University of California, Los Angeles) Cardiomyopathy Center, Ronald Reagan UCLA Medical Center, Los Angeles.

"The findings reinforce the significant survival benefits ARNI therapy could offer to those living with HFrEF, and offer managed care executives compelling new data at the population level to consider when evaluating reimbursement decisions for HF treatments," says Fonarow.

The analysis also suggests that delaying routine use of sacubitril/ valsartan in clinical practice could have a substantial negative effect on patients, given the expected risk-benefit profile, as it could result in failure to prevent tens of thousands of deaths, according to Fonarow.

Heart failure is chronic, costly and deadly-the condition contributes to more than 300,000 deaths in the U.S. every year, and despite available medicines, about half of patients diagnosed with HF die within five years.

"These findings if applied may substantially impact the national health of the HFrEF population, offering significant clinical benefit in preventing or postponing death when applied in clinical practice," he says. "We estimated that nearly 84% of HFrEF patients-2.2 million people-in the U.S. may be candidates for treatment with ARNI therapy."

Together with the strong recommendation for ARNI therapy in the recently released ACC/AHA/HFSA HF Treatment Guidelines, these findings underscore the potential of ARNI therapy as a standard therapy for chronic HFrEF patients, according to the authors.

The analysis was based on an application of the results of PARADIGM-HF, the largest clinical trial ever conducted in HF with more than 8,400 patients studied, to published heart failure data. In the PARADIGM-HF study, sacubritril/valsartan was shown to significantly reduce the relative risk of cardiovascular death or heart failure hospitalization by 20% over ACE-inhibitor enalapril.