Dr Alexander Lyon, a heart failure specialist at The Physicians' Clinic, is excited about the new heart failure drug, Entresto, which has just been approved by NICE for use in the UK. "For over 20 years a medication called an ACE inhibitor has been the cornerstone of treatment for people with heart failure when the pumping function of the heart is reduced. Previously any new medications have always been tested in addition to ACE inhibitors. This approach was challenged in the PARADIGM-HF trial, where Entresto was compared head-to-head with the best ACE inhibitor (enalapril) for heart failure. The trial enrolled over 8400 people with heart failure and ongoing problems from their heart condition. Entresto was a better treatment than the 'gold standard' ACE inhibitor, reducing hospital emergencies. It was found that more people were living longer in the group receiving Entresto," Dr Lyon explained.
NICE, the regulatory body of the NHS for new treatments, has announced approval of Entresto for individuals with heart failure who are currently taking an ACE inhibitor (such as enalapril, ramipril, perindopril, lisinopril) or similar heart failure medication called an angiotensin receptor antagonist (such as valsartan, candesartan, losartan, irbesartan), and who continue to have both reduced heart function and are still limited by their heart condition.
NICE have emphasised the importance that Entresto is only started by heart failure specialists who can oversee the transition from the patient's current medication (ACE inhibitors or angiotensin receptor antagonists) to Entresto.
Dr Lyon has given lectures to UK cardiologists to educate them about this new medication. "There are two active components to Entresto, so people can receive 2 treatments in one pill. One part is valsartan, an established angiotensin receptor antagonist. The second part, called sacubitril, is a novel drug with a completely new mode of action compared to medication we currently use", Dr Lyon explains. "Understanding how Enstresto works is critical so doctors can safely switch the people they are caring for with heart failure from their current medication to Entresto, and monitor their progress effectively. This is an exciting new medicine for people with heart failure!"
Disclaimer: Dr Lyon is a consultant to Novartis, who developed Entresto, and received fees for participating in Global, European and UK advisory boards, and speaker fees for lectures on Entresto.