Pharmacokinetics and Pharmacodynamics of Sacubitril/Valsartan in Maintenance Hemodialysis Patients with Heart Failure

Feng, Zhonglin; Wang, Xipei; Zhang, Li; Apaer, Rizvangul; Xu, Lixia; Ma, Jianchao; Che, Huimin; Tang, Bin; Xiong, Yuwang; Xia, Yu-Bin; Xiao, Jie; Su, Xin; Wang, Yamei; Dou, Xianrui; Chen, Jinzhong; Mei, Lifan; Xue, Zhiqiang; Kong, Yuanyuan; Li, Sijia; Zhang, Hong; Lin, Tzu Chen; Wen, Feng; Fu, Xin; Tao, Yiming; Fu, Lei; Li, Zhuo; Huang, Renwei; Ye, Zhiming; He, Chaosheng; Shi, Wei; Liang, Xinling; Ke, Guibao; Liu, Shuangxin

doi:10.1159/000519643

Cited by 11 publications

(10 citation statements)

References 32 publications

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“… B-blocker: n = 16, CCB: n = 5, ACEI/ARB: n = 0, MCA: n = 2 Feng et al. , 27 2022 China 2019–2020 Prospective, observational, self-controlled study 50–100 mg twice a day 18 mo 11 Median 50 (IQR 39–72) 5 (45%) HD HFrEF and HFmrEF, LVEF 40% and 40–50% N/A Fu et al. , 28 2021 China 2018–2019 Retrospective, observational self-controlled study 50–100 mg twice a day 3–12 mo 21 Median 55 (IQR 38–61) 14 (67%) PD HFpEF, LVEF >50% Hypertension: n = 21, Diabetes: n = 5, CAD: n = 21 B-blocker: n = 11, CCB: n = 21, ACEI/ARB: n = 6, Diuretic: n = 10 Guo et al.…”

Section: Resultsmentioning

confidence: 99%

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Systematic Review of Cardiovascular Benefits and Safety of Sacubitril-Valsartan in End-Stage Kidney Disease

Charkviani,

Krisanapan,

Thongprayoon

et al. 2024

Kidney International Reports

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Section: Resultsmentioning

confidence: 99%

“…Change of LVEF was evaluated in a total of 9 studies. 13 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 36 The duration of follow-up ranged from 3 to 18 months (refer to Table 1 for details). All of these studies were before and after studies and reported LVEF at baseline and after the intervention in the same group of patients.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of Cardiovascular Benefits and Safety of Sacubitril-Valsartan in End-Stage Kidney Disease

Charkviani,

Krisanapan,

Thongprayoon

et al. 2024

Kidney International Reports

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“…Sacubitrilat, the active metabolite of the prodrug sacubitril, and valsartan were not removed by dialysis filtration, but their levels remained within the safe ranges on the interdialytic interval days. Moreover, S/V up to 100 mg twice daily was safe and associated with a significant improvement in EF and reductions in NT‐proBNP and hsTnT (all P < 0.05) in HF patients undergoing haemodialysis 75 …”

Section: Efficacy and Safety In Subgroups Of Interestmentioning

confidence: 92%

“…Moreover, S/V up to 100 mg twice daily was safe and associated with a significant improvement in EF and reductions in NT-proBNP and hsTnT (all P < 0.05) in HF patients undergoing haemodialysis. 75…”

Section: Safety In Chronic Kidney Disease Patientsmentioning

confidence: 99%

Sacubitril/valsartan in heart failure: efficacy and safety in and outside clinical trials

Abdin

Schulz²,

Riemer

et al. 2022

ESC Heart Failure

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Heart failure (HF) treatment has changed substantially over the last 30 years, leading to significant reductions in mortality and hospital admissions in patients with HF with reduced ejection fraction (HFrEF). Currently, the optimization of guideline‐directed chronic HF therapy remains the mainstay to further improve quality of life, mortality, and HF hospitalizations for patients with HFrEF. The angiotensin receptor‐neprilysin inhibitor sacubitril/valsartan (S/V) has an important role in the treatment of patients with HFrEF. The PARADIGM‐HF (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure) randomized controlled trial has established solid evidence for the treatment of HFrEF in various subgroups. Apart from HFrEF, several studies have been conducted using S/V in various indications: patients hospitalized with acute decompensated HF, HF with preserved ejection fraction, acute myocardial infarction with reduced ejection fraction, uncontrolled and resistant hypertension, and chronic kidney disease. Data from the German Institute for Drug Use Evaluation reveal that implementation of S/V has increased steadily over time and, by the end of 2021, an estimated 266 000 patients were treated with S/V in Germany. The estimated cumulative real‐world patient exposure is >5.5 million patient‐treatment years worldwide. The number of patients treated with S/V largely exceeds the number of patients treated in clinical trials, and the current indication for S/V is larger than the strict inclusion/exclusion criteria of the randomized trials. Especially elderly patients, women, and patients with more and more severe comorbidities are underrepresented in the clinical trials. We therefore aimed to summarize the importance of S/V in HF in terms of efficacy and safety in clinical trials and daily clinical practice.

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“…Therefore, in patients with heart failure, directly initiating ARNI can avoid the treatment delay caused by initial ACEI intake followed by a switch to ARNI. The 2021 US expert consensus on the management of patients with HFrEF states that ARNI should be preferred over ACEI/ARB for patients with HFrEF ( 74 ).…”

Section: Use Of Arni In Non-dialysis Patients With Ckdmentioning

confidence: 99%

Application of Angiotensin Receptor–Neprilysin Inhibitor in Chronic Kidney Disease Patients: Chinese Expert Consensus

Gan

Lyu²,

Yang³

et al. 2022

Front. Med.

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Chronic kidney disease (CKD) is a global public health problem, and cardiovascular disease is the most common cause of death in patients with CKD. The incidence and prevalence of cardiovascular events during the early stages of CKD increases significantly with a decline in renal function. More than 50% of dialysis patients die from cardiovascular disease, including coronary heart disease, heart failure, arrhythmia, and sudden cardiac death. Therefore, developing effective methods to control risk factors and improve prognosis is the primary focus during the diagnosis and treatment of CKD. For example, the SPRINT study demonstrated that CKD drugs are effective in reducing cardiovascular and cerebrovascular events by controlling blood pressure. Uncontrolled blood pressure not only increases the risk of these events but also accelerates the progression of CKD. A co-crystal complex of sacubitril, which is a neprilysin inhibitor, and valsartan, which is an angiotensin receptor blockade, has the potential to be widely used against CKD. Sacubitril inhibits neprilysin, which further reduces the degradation of natriuretic peptides and enhances the beneficial effects of the natriuretic peptide system. In contrast, valsartan alone can block the angiotensin II-1 (AT1) receptor and therefore inhibit the renin–angiotensin–aldosterone system. These two components can act synergistically to relax blood vessels, prevent and reverse cardiovascular remodeling, and promote natriuresis. Recent studies have repeatedly confirmed that the first and so far the only angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan can reduce blood pressure more effectively than renin–angiotensin system inhibitors and improve the prognosis of heart failure in patients with CKD. Here, we propose clinical recommendations based on an expert consensus to guide ARNI-based therapeutics and reduce the occurrence of cardiovascular events in patients with CKD.

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Pharmacokinetics and Pharmacodynamics of Sacubitril/Valsartan in Maintenance Hemodialysis Patients with Heart Failure

Cited by 11 publications

References 32 publications

Systematic Review of Cardiovascular Benefits and Safety of Sacubitril-Valsartan in End-Stage Kidney Disease

Systematic Review of Cardiovascular Benefits and Safety of Sacubitril-Valsartan in End-Stage Kidney Disease

Sacubitril/valsartan in heart failure: efficacy and safety in and outside clinical trials

Application of Angiotensin Receptor–Neprilysin Inhibitor in Chronic Kidney Disease Patients: Chinese Expert Consensus

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