The Effects of LCZ696 in Patients With Hypertension Compared With Angiotensin Receptor Blockers

Abstract

LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, has been demonstrated to have greater advantages in the treatment of heart failure compared with angiotensin-converting enzyme inhibitors, enalapril, or angiotensin receptor blockers (ARBs). However, studies that compared the efficacy and safety of LCZ696 against valsartan in patients with hypertension are limited. To provide further evidence for the benefits of LCZ696 and to make this assessment, a meta-analysis of randomized controlled trials (RCTs) was performed. The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, MEDLINE, PubMed, and ClinicalTrials.gov were searched for RCTs. Twelve studies involving 3816 patients were eligible for inclusion. Seven studies compared LCZ696 with valsartan, and 5 studies compared LCZ696 with olmesartan. LCZ696 showed a significantly greater reduction in systolic blood pressure (BP; mean difference [MD] = -5.43 mm Hg; 95% confidence interval [CI]: -6.36 to -4.49 mm Hg; P < .001), diastolic BP (MD = -2.34 mm Hg; 95% CI: -2.67 to -2.01 mm Hg; P < .001), 24-hour ambulatory systolic BP (MD = -3.57 mm Hg, 95% CI: -4.29 to -2.85 mm Hg; P < .001), and 24-hour ambulatory diastolic BP (MD = -1.32 mm Hg, 95% CI: -1.77 to -0.78 mm Hg; P < .001) from the baseline than ARBs. LCZ696 was more effective in reducing BP (odds ratio [OR] = 5.34; 95% CI: 4.49-6.36; P < .01) and had a higher rate of BP control compared with ARBs (OR = 1.52; 95% CI: 1.37-1.69; P < .01). LCZ696 had no difference in the incidence of adverse events (OR = 1.05; 95% CI: 0.94-1.18; P = .38) or serious adverse events (OR = 0.80; 95% CI: 0.51-1.24; P = .31) compared to ARBs. This meta-analysis revealed that LCZ696 has a greater antihypertensive efficacy and an equal tolerability profile.

Effects of LCZ696 (Sacubitril/Valsartan) on Blood Pressure in Patients with Hypertension: A Meta-Analysis of Randomized Controlled Trials

“…In our meta-analysis, we found that LCZ696 (100, 200, and 400 mg) produced significantly greater reductions in SBP, DBP, 24 h ASBP, and 24 h ADBP than ARBs alone in hypertensive patients. These results are consistent with the meta-analyses of Ye et al [21] and Zhao et al [23]. Compared with ARBs alone, LCZ696 causes a greater reduction in blood pressure, mainly attributed to RAS inhibition occurring simultaneously with neprilysin inhibition.…”

Antihypertensive Efficacy of LCZ696 (Sacubitril/Valsartan) in Hypertension

“…The BP-lowering effect was consistently observed across different clinical studies and was found to be dose-dependent and largely independent of age and baseline BP values, which ranged within stage 1–2 hypertension. These results confirmed and extended those of previous analyses, which showed similar beneficial effects on BP reduction [11].…”

LCZ696, a promising novel agent in treating hypertension (a meta-analysis of randomized controlled trials)

“…In the study by Zhao et al[ 37 ], two drugs, including valsartan and olmesartan were used in ARB group, and the dose of olmesartan varied at 80mg, 160mg and 320mg in NCT00549770. The category and dose of drugs is likely to affect the effectiveness of reducing blood pressure.…”