Supramolecular complex sacubitril/valsartan - the first representative of a new class of drugs for the treatment of chronic heart failure

Authors

  • T. V. Ashcheulova Kharkiv National Medical University, Ukraine,
  • K. M. Kompaniiets Kharkiv National Medical University, Ukraine,
  • N. M. Herasimchuk Kharkiv National Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2019.3.188964

Keywords:

chronic heart failure, sacubitril/valsartan, left ventricular ejection fraction, natriuretic peptide, neutral endopeptidase

Abstract

 

The average prevalence of сhronic heart failure in the adult population, according to the statistics of different countries, ranges from 1.5 % to 5.5 % and therefore the study of this problem and of finding new approaches to the treatment of сhronic heart failure is also still relevant at present.

Objective is to show an innovative strategy in the treatment of сhronic heart failure, to show the benefits of using the combined drug sacubitril/valsartan (LCZ696) in comparison with the group of the mentioned above drugs for treating patients with сhronic heart failure and a reduced left ventricular ejection fraction, according to the results of a large randomized clinical research, based on its biochemical properties.

Conclusions. The main positive effects of sacubitril and valsartan in patients with сhronic heart failure are associated with an increase in the amount of the natriuretic peptide and the simultaneous suppression by valsartan of the negative effects of angiotensin II. The indication for the use of the sakubitril / valsartan complex is сhronic heart failure (II – IV FC according to the NYHA classification) in patients with systolic dysfunction in order to reduce the risk of cardiovascular mortality and hospitalization for heart failure.

 

References

Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Colvin, M. M., . . . Westlake, C. (2016). 2016 ACC/AHA/HFSA focused update on new pharmacological therapy for heart failure: An update of the 2013 ACCF/AHA guideline for the management of heart failure: A report of the American College of Cardiology/American heart association Task Force on Clinical practice guidelines and the heart failure society of America. Journal of the American College of Cardiology, 68(13), 1476-1488. https://doi.org/10.1016/j.jacc.2016.05.011

Molchanov, D. (2016). VI nauchno-prakticheskaya konferentsiya Ukrainskoy Assotsiatsii spetsialistov po serdechnoy nedostatochnosti: obzor materialov [VI scientific-practical conference of the Ukrainian Association of Specialists in Heart Failure: a review of materials]. Sertseva nedostatnist. 2, 60-71. [in Russian].

Reynolds, K., Butler, M. G., Kimes, T. M., Rosales, A. G., Chan, W., & Nichols, G. A. (2015). Relation of Acute Heart Failure Hospital Length of Stay to Subsequent Readmission and All-Cause Mortality. American Journal of Cardiology, 116(3), 400–405. https://doi.org/10.1016/j.amjcard.2015.04.052

Gordin, J. S., & Fonarow, G. C. (2016). New medications for heart failure. Trends in Cardiovascular Medicine, 26(6), 485-492. https://doi.org/10.1016/j.tcm.2016.02.008

Voronkov, L. H. (2012). Patsiient iz HSN v Ukraini : analiz danykh populiatsii patsiientiv, obstezhenykh u ramkakh pershoho natsionalnoho zrizovoho doslidzhennia UNIVERS [A patient with CHF in Ukraine: an analysis of the data of the population of patients surveyed in the framework of the first national study UNIVERS]. Sertseva nedostatnist, 2, 6-13. [in Ukrainian].

Ambrosy, A. P., Fonarow, G. C., Butler, J., Chioncel, O., Greene, S. J., Vaduganathan, M., . . . Gheorghiade, M. (2014). The Global Health and Economic Burden of Hospitalizations for Heart Failure. Journal of the American College of Cardiology, 63(12), 1123-1133. https://doi.org/10.1016/j.jacc.2013.11.053

Kentsch, M., & Otter, W. (1999). Novel neurohormonal modulators in cardiovascular disorders. The therapeutic potential of endopeptidase inhibitors. Drugs in R&D. https://doi.org/10.2165/00126839-199901040-00011

Dalzell, J. R., Seed, A., Berry, C., Whelan, C. J., Petrie, M. C., Padmanabhan, N., . . . McMurray J. V. (2014). Effects of Neutral Endopeptidase (Neprilysin) Inhibition on the Response to Other Vasoactive Peptides in Small Human Resistance Arteries: Studies with Thiorphan and Omapatrilat. Cardiovascular Therapeutics, 32(1), 13-18. https://doi.org/10.1111/1755-5922.12053

Wong P. C. Y., Guo J. & Zhang A. (2017). The renal and cardiovascular effects of natriuretic peptides. Advances in Physiology Education, 41(2), 179-185. https://doi.org/10.1152/advan.00177.2016

Kerkela, R., Ulvila, J., & Magga, J. (2015). Natriuretic Peptides in the Regulation of Cardiovascular Physiology and Metabolic Events. Journal of the American Heart Association, 4(10). https://doi.org/10.1161/jaha.115.002423

Tonne, J. M., Campbell, J. M., Cataliotti, A., Ohmine, S., Thatava, T., Sakuma, T., . . . Ikeda, Y. (2011). Secretion of Glycosylated Pro-B-Type Natriuretic Peptide from Normal Cardiomyocytes. Clinical Chemistry, 57(6), 864-873. https://doi.org/10.1373/clinchem.2010.157438

Kuhn, M. (2016). Molecular physiology of membrane guanylyl cyclase receptors. Physiological Reviews, 96(2), 751-804. https://doi.org/10.1152/physrev.00022.2015

Santhekadur, P. K., Kumar, D. P., Seneshaw, M., Mirshahi, F., & Sanyal, A. J. (2017). The multifaceted role of natriuretic peptides in metabolic syndrome. Biomedicine & Pharmacotherapy, 92, 826-835. https://doi.org/10.1016/j.biopha.2017.05.136

Moyes, A. J., Khambata, R. S., Villar, I., Bubb, K. J., Baliga, R. S., Lumsden, N. G., . . . Hobbs, A. J. (2014). Endothelial C-type natriuretic peptide maintains vascular homeostasis. Journal of Clinical Investigation, 124(9), 4039-4051. https://doi.org/10.1172/jci74281

Ichiki, T., & Burnett, J. C. (2017). Atrial Natriuretic Peptide - Old But New Therapeutic in Cardiovascular Diseases. Circulation Journal, 81(7), 913-919. https://doi.org/10.1253/circj.CJ-17-0499

Theilig, F., & Wu, Q. Y. (2015). ANP-induced signaling cascade and its implications in renal pathophysiology. American Journal of Physiology-Renal Physiology, 308(10), F1047-F1055. https://doi.org/10.1152/ajprenal.00164.2014

Yoshihara, F., Tokudome, T., Kishimoto, I., Otani, K., Kuwabara, A., Horio, T., . . . Kangawa, K. (2015). Aggravated renal tubular damage and interstitial fibrosis in mice lacking guanylyl cyclase-A (GC-A), a receptor for atrial and B-type natriuretic peptides. Clinical and Experimental Nephrology, 19(2), 197-207. https://doi.org/10.1007/s10157-014-0982-1

Buttgereit, J., Shanks, J., Li, D., Hao, G., Athwal, A., Langenickel, T. H., . . . Herring, N. (2016). C-type natriuretic peptide and natriuretic peptide receptor B signalling inhibits cardiac sympathetic neurotransmission and autonomic function. Cardiovascular Research, 112(3), 637-644. https://doi.org/10.1093/cvr/cvw184

Volpe, M., Rubattu, S., & Burnett, J. (2014). Natriuretic peptides in cardiovascular diseases: current use and perspectives. European Heart Journal, 35(7), 419-+. https://doi.org/10.1093/eurheartj/eht466

Holditch, S. J., Schreiber, C. A., Nini, R., Tonne, J. M., Peng, K. W., Geurts, A., . . . Ikeda, Y. (2015). B-Type Natriuretic Peptide Deletion Leads to Progressive Hypertension, Associated Organ Damage, and Reduced Survival Novel Model for Human Hypertension. Hypertension, 66(1), 199-210. https://doi.org/10.1161/hypertensionaha.115.05610

Jaffe, A. S., Apple, F. S., Mebazaa, A., & Vodovar, N. (2015). Unraveling N-Terminal Pro-B-Type Natriuretic Peptide: Another Piece to a Very Complex Puzzle in Heart Failure Patients. Clinical Chemistry, 61(8), 1016-1018. https://doi.org/10.1373/clinchem.2015.243626

Richards, A. M., Wittert, G. A., Crozier, I. G., Espiner, E. A., Yandle, T. G., Ikram, H., & Frampton, C. (1993). Chronic inhibition of endopeptidase 24.11 in essential-hypertension - evidence for enhanced atrial-natriuretic-peptide and angiotensin-II. Journal of Hypertension, 11(4), 407-416. https://doi.org/10.1097/00004872-199304000-00011

Kuzmin, O. B. Zhezha, V. V., Belyanin, V. V., Landar, L. N. (2016). Glomerulyarnaya gipertenziya: molekulyarnye mekhanizmy povrezhdeniya podotsitov i mezangial'nykh kletok : (obzor) [Glomerular hypertension: molecular mechanisms of podocyte and mesangial cells damage]. Nefrologiya, 20(4), 39-45. [in Russian].

Kostis, O. B., Packer, M., Black, H. R., Schmieder, R., Henry, D., & Levy, E. (2004). Omapatrilat and enalapril in patients with hypertension: The omapatrilat cardiovascular treatment vs. enalapril (OCTAVE) trial. American Journal of Hypertension, 17(2), 103-111. https://doi.org/10.1016/j.amjhyper.2003.09.014

Gu, J., Noe, A., Chandra, P., Al-Fayoumi, S., Ligueros-Saylan, M., Sarangapani, R., . . . Dole, W. P. (2010). Pharmacokinetics and Pharmacodynamics of LCZ696, a Novel Dual-Acting Angiotensin Receptor-Neprilysin Inhibitor (ARNi). Journal of Clinical Pharmacology, 50(4), 401-414. https://doi.org/10.1177/0091270009343932

Kusaka, H., Sueta, D., Koibuchi, N., Hasegawa, Y., Nakagawa, T., Lin, B. W., . . . Kim-Mitsuyama, S. (2015). LCZ696, Angiotensin II Receptor-Neprilysin Inhibitor, Ameliorates High-Salt-Induced Hypertension and Cardiovascular Injury More Than Valsartan Alone. American Journal of Hypertension, 28(12), 1409-1417. https://doi.org/10.1093/ajh/hpv015

McMurray, J. J. V., Packer, M., Desai, A. S., Gong, J. J., Lefkowitz, M. P., Rizkala, A. R., . . . Comm, P.-H. I. (2014). Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure. New England Journal of Medicine, 371(11), 993-1004. https://doi.org/10.1056/NEJMoa1409077

Ruilope, L. M., Dukat, A., Bohm, M., Lacourciere, Y., Gong, J. J., & Lefkowitz, M. P. (2010). Blood-pressure reduction with LCZ696, a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin: a randomised, double-blind, placebo-controlled, active comparator study. Lancet, 375(9722), 1255-1266. https://doi.org/10.1016/s0140-6736(09)61966-8

Solomon, S. D., Zile, M., Pieske, B., Voors, A. A., Shah, A., Kraigher-Krainer, E., . . . Prospective Comparison, A.A.R.B.M. (2012). The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction: a phase 2 double-blind randomised controlled trial. Lancet, 380(9851), 1387-1395. https://doi.org/10.1016/s0140-6736(12)61227-6

Kario, K., Sun, N. L., Chiang, F. T., Supasyndh, O., Baek, S. H., Inubushi-Molessa, A., . . . Zhang, J. (2014). Efficacy and Safety of LCZ696, a First-in-Class Angiotensin Receptor Neprilysin Inhibitor, in Asian Patients With Hypertension. Hypertension, 63(4), 698-705. https://doi.org/10.1161/hypertensionaha.113.02002

Volpe, M., Rubattu, S., & Battistoni, A. (2019). ARNi: A Novel Approach to Counteract Cardiovascular Diseases. International Journal of Molecular Sciences, 20(9). https://doi.org/10.3390/ijms20092092

Seferovic, J. P., Claggett, B., Seidelmann, S. B., Seely, E. W., Packer, M., Zile, M. R., . . . Solomon, S. D. (2017). Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial. Lancet Diabetes & Endocrinology, 5(5), 333-340. https://doi.org/10.1016/s2213-8587(17)30087-6

Menendez, J. T. (2016). The Mechanism of Action of LCZ696. Cardiac Failure Review. 2(1), 40-46. https://doi.org/10.15420/cfr.2016:1:1

Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., . . . Guazzi, M. (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European Journal of Heart Failure, 18(8), 891-975. https://doi.org/10.1002/ejhf.592

New medicine to treat heart failure recommended for approval. (2015, September). Retrieved from https://www.ema.europa.eu/en/news/new-medicine-treat-heart-failure-recommended-approval

Jhund, P. S., & McMurray, J. J. V. (2016). The neprilysin pathway in heart failure: a review and guide on the use of sacubitril/valsartan. Heart, 102(17), 1342-1347. https://doi.org/10.1136/heartjnl-2014-306775

Wachter, R., Senni, M., Belohlavek, J., Butylin, D., Noe, A., Pascual-Figal, D., & Investigators, T. S. (2018). Initiation of sacubitril/valsartan in hospitalized patients with heart failure with reduced ejection fraction after hemodynamic stabilization: primary results of the TRANSITION study. European Heart Journal, 39, 167-167. https://doi.org/10.1093/eurheartj/ehy564.p886

Downloads

How to Cite

1.
Ashcheulova TV, Kompaniiets KM, Herasimchuk NM. Supramolecular complex sacubitril/valsartan - the first representative of a new class of drugs for the treatment of chronic heart failure. Pathologia [Internet]. 2019Dec.23 [cited 2024Dec.23];(3). Available from: http://pat.zsmu.edu.ua/article/view/188964

Issue

No. 3 (2019)

Section

Review

License

Authors who publish with this journal agree to the following terms:

    1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Лицензия Creative Commons
    1. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

  1. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).