Sacubitril/Valsartan: A Game Changer in the Treatment for Heart Failure
With an estimated prevalence of 5.8 million in the United States and over 23 million people globally, heart failure (HF) is gradually becoming an epidemic. Despite the use of conventional medical therapies such as angiotensin-converting enzyme inhibitors, beta-adrenergic blockers, angiotensin receptor blockers, and mineralocorticoid receptor antagonists for management of heart failure patients for almost two decades, HF remains a leading cause of morbidity, mortality, and healthcare expenditures. The Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitor with Angiotensin-Converting Enzyme Inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF) trial provided compelling evidence for the cardiovascular and mortality benefit of sacubitril/valsartan when compared to enalapril in patients with heart failure and reduced ejection fraction (HFrEF). Following the trial, the US Food and Drug Administration (U.S. FDA) approved this drug for the treatment of HF. There have been several other trials proving other important benefits of sacubitril/valsartan along with other ongoing trials. In this review, we will discuss about the characteristics of sacubitril/valsartan, its role in the management of heart failure, the various ongoing and already performed trials and their results to understand the current role and future uses of this combination drug. A systematic literature search was conducted using key words from relevant articles, and MeSh terms on google scholar and PubMed. Data were abstracted according to their relevance to subheadings of the review and synthesis of concepts done through multiple reviews by at least two reviewers for any subsection.
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