Potential beneficial effects of sacubitril-valsartan in renal disease: a new field for a new drug

Expert Opin Investig Drugs. 2017 May;26(5):651-659. doi: 10.1080/13543784.2017.1317345. Epub 2017 Apr 21.

Abstract

Patients with renal dysfunction are at a higher risk of cardiovascular disease (CVD), which often shares manifestations with heart failure (HF). Last year, the FDA approved the use of sacubitril-valsartan in patients with HF. This dual-acting agent enhances the functions of natriuretic peptides and inhibits the renin-angiotensin system. Areas covered: This review summarizes the existing preclinical and clinical studies carried out with sacubitril-valsartan (and other drugs with similar pharmacological mechanisms) in HF and hypertensive patients. We put the focus on the renal data provided by these studies. Data were obtained from English peer-reviewed articles on PubMed and clinical trials registered in ClinicalTrials.gov. Expert opinion: Overall, sacubitril-valsartan might be a promising therapeutic approach in patients with renal dysfunction. Renal conditions with marked CV risk, such as arterionephrosclerosis, could constitute a particular setting where to evaluate the impact of the drug. Nevertheless, large, randomized trials are needed to confirm the beneficial effects and safety profile of the drug in renal patients, as well as to elucidate some concerns observed in HF trials, such as the slight increase in proteinuria.

Keywords: LCZ696; Sacubitril; heart failure; renal disease; valsartan.

Publication types

  • Review

MeSH terms

  • Aminobutyrates / adverse effects
  • Aminobutyrates / pharmacology
  • Aminobutyrates / therapeutic use*
  • Angiotensin Receptor Antagonists / adverse effects
  • Angiotensin Receptor Antagonists / pharmacology
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Animals
  • Biphenyl Compounds
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / etiology
  • Drug Combinations
  • Heart Failure / drug therapy
  • Humans
  • Hypertension / drug therapy
  • Kidney Diseases / complications
  • Kidney Diseases / drug therapy*
  • Renin-Angiotensin System / drug effects
  • Tetrazoles / adverse effects
  • Tetrazoles / pharmacology
  • Tetrazoles / therapeutic use*
  • Valsartan

Substances

  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Biphenyl Compounds
  • Drug Combinations
  • Tetrazoles
  • Valsartan
  • sacubitril and valsartan sodium hydrate drug combination