- Keywords
- Entresto,
- MeSH
- Aminobutyrates administration & dosage MeSH
- Antihypertensive Agents administration & dosage MeSH
- Biphenyl Compounds administration & dosage MeSH
- Chronic Disease MeSH
- Glomerular Filtration Rate drug effects MeSH
- Drug Therapy, Combination MeSH
- Comorbidity MeSH
- Humans MeSH
- Disease Management MeSH
- Heart Failure * drug therapy classification MeSH
- Severity of Illness Index MeSH
- Valsartan administration & dosage MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- Keywords
- Entresto (sacubitril/valsartan),
- MeSH
- Enalapril therapeutic use MeSH
- Humans MeSH
- Death, Sudden, Cardiac prevention & control MeSH
- Natriuretic Peptides blood MeSH
- Neprilysin administration & dosage pharmacology MeSH
- Receptors, Angiotensin drug effects MeSH
- Heart Failure, Systolic * diagnostic imaging drug therapy blood MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
Kombinace sakubitril/valsartan je duální antagonista receptoru pro angiotenzin II a neprilysinu (ARNI). Dosud největší klinická studie provedená u pacientů se srdečním selháním se sníženou ejekční frakcí (HFrEF) PARADIGM-HF prokázala superioritu kombinace sakubitril/valsartan vůči enalaprilu, a to nejen v primárním sledovaném parametru kardiovaskulární mortality a hospitalizace pro srdeční selhání, ale i v mortalitě celkové a dalších ukazatelích. Léčba byla dobře snášena. V článku jsou popsány mezinárodní, převážně pozitivní, zkušenosti s převodem pacientů na sakubitril/ valsartan a vývoj klinického stavu těchto nemocných, včetně jejich laboratorních parametrů, kvality života i echokardiografických nálezů.
The combination sacubitril/valsartan is the first drug from the angiotenzin receptor blocker and neprilysin inhibitor group (ARNI). The PARADIGM-HF study is the largest study ever in patients with heart failure with reduced left ventricle ejection fraction. The ARNI was superior to enalapril not only in the primary outcome of the study – cardiovascular mortality and hospitalization for heart failure, but also in total mortality and other followed parameters. The new treatment is well tolerated and changes the natural course of heart failure. The article describes international clinical experience with starting sacubitril/valsartan treatment, the follow up of clinical state of treated patients, including their laboratory parameters, quality of life or echocardiographic findings.
- Keywords
- Entresto (sacubitril/valsartan),
- MeSH
- Aminobutyrates administration & dosage pharmacology MeSH
- Angiotensin Receptor Antagonists administration & dosage pharmacology MeSH
- Angiotensin II Type 1 Receptor Blockers administration & dosage pharmacology adverse effects MeSH
- Ventricular Function, Left drug effects MeSH
- Quality of Life MeSH
- Humans MeSH
- Neprilysin antagonists & inhibitors MeSH
- Heart Failure * diagnostic imaging drug therapy MeSH
- Tetrazoles administration & dosage pharmacology MeSH
- Check Tag
- Humans MeSH
- Keywords
- Entresto (sacubitril/valsartan),
- MeSH
- Aminobutyrates administration & dosage pharmacology MeSH
- Angiotensin Receptor Antagonists administration & dosage pharmacology MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Ventricular Dysfunction, Left diagnostic imaging drug therapy complications MeSH
- Drug Combinations MeSH
- Sodium-Glucose Transporter 2 Inhibitors therapeutic use MeSH
- Tachycardia, Ventricular surgery MeSH
- Humans MeSH
- Aged, 80 and over MeSH
- Heart Failure * complications pathology MeSH
- Tetrazoles administration & dosage pharmacology MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Publication type
- Case Reports MeSH
- Keywords
- Entresto,
- MeSH
- Angiotensin II Type 1 Receptor Blockers administration & dosage MeSH
- Double-Blind Method MeSH
- Drug Combinations MeSH
- Risk Assessment MeSH
- Angiotensin-Converting Enzyme Inhibitors administration & dosage MeSH
- Contraindications, Drug MeSH
- Humans MeSH
- Neprilysin antagonists & inhibitors MeSH
- Heart Failure * epidemiology drug therapy mortality MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Meta-Analysis MeSH
- Randomized Controlled Trial MeSH
- Keywords
- ENTRESTO Novartis,
- MeSH
- Angiotensin Receptor Antagonists administration & dosage pharmacology MeSH
- Chronic Disease drug therapy MeSH
- Enalapril administration & dosage pharmacokinetics MeSH
- Drug Combinations MeSH
- Glomerular Filtration Rate drug effects MeSH
- Humans MeSH
- Natriuretic Peptides analysis metabolism MeSH
- Neprilysin antagonists & inhibitors MeSH
- Ventricular Remodeling drug effects MeSH
- Heart Failure * drug therapy MeSH
- Tetrazoles pharmacology therapeutic use MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
Z hlediska farmakoterapie srdečního selhání se sníženou ejekční frakcí levé komory (heart failure with reduced ejection fraction, HFrEF) je důležité, že komorbidity mohou ovlivňovat farmakokinetiku a farmakodynamiku použitých léků, a tím i účinnost a bezpečnost léčby. Na druhou stranu může farmakoterapie HFrEF v některých případech negativně ovlivňovat vývoj komorbidit. V případě kombinace sacubitril/valsartanu je doporučeno u pacientů s glomerulární filtrací 30-60 ml/min/1,73 m2, jaterní dysfunkcí stupně B podle Childovy-Pughovy klasifikace nebo systolickým krevním tlakem 100-110 mm Hg zahájit léčbu nejnižší dávkou a pečlivě pacienty monitorovat. Významným nálezem je zpomalení poklesu glomerulární filtrace a nižší výskyt závažné hyperkalemie při léčbě touto kombinací v porovnání s enalaprilem. Překvapením je snížení glykovaného hemoglobinu a sérové koncentrace kyseliny močové při léčbě kombinací sacubitril/valsartanu, což otvírá nové možnosti pro individualizovanou léčbu HFrEF. Univerzálním nálezem je u většiny komorbidit přetrvávající benefit z léčby touto kombinací v porovnání s enalaprilem.
Comorbidities may influence either pharmacokinetics or pharmacodynamics of drugs used in heart failure with reduced ejection fraction (HFrEF), and thus modify their efficacy and safety. On the other hand, pharmacotherapy of HFrEF may contribute to worsening of comorbidities. In patients with glomerular filtration rate of 30-60 ml/min/1,73 m2, liver dysfunction Child-Pugh B or systolic blood pressure of 100-110 mm Hg, it is recommended to initiate treatment with sacubitril/valsartan with the lowest dose and provide a careful follow-up. A significant benefit of treatment with sacubitril/valsartan as compared with enalapril is a slowing the impairment of glomerular filtration rate and a lower incidence of severe hyperkalaemia. Surprisingly, treatment with sacubitril/valsartan resulted into a better glycaemic control and reduction of serum uric acid concentration, which may create novel opportunities for individualized treatment of HFrEF. Importantly, sacubitril/valsartan provides in most comorbidities a significant benefit in comparison with enalapril.
- Keywords
- Entresto,
- MeSH
- Aminobutyrates administration & dosage pharmacokinetics pharmacology MeSH
- Angiotensin Receptor Antagonists pharmacokinetics pharmacology adverse effects therapeutic use MeSH
- Diabetes Mellitus diagnosis drug therapy MeSH
- Drug Combinations MeSH
- Glomerular Filtration Rate drug effects MeSH
- Hyperkalemia chemically induced MeSH
- Hypertension drug therapy MeSH
- Hyperuricemia chemically induced MeSH
- Comorbidity MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Heart Failure * drug therapy complications physiopathology MeSH
- Tetrazoles administration & dosage pharmacokinetics pharmacology MeSH
- Valsartan administration & dosage pharmacokinetics pharmacology MeSH
- Dose-Response Relationship, Drug MeSH
- Check Tag
- Humans MeSH
- Publication type
- Clinical Study MeSH
- Keywords
- Entresto,
- MeSH
- Aminobutyrates pharmacology therapeutic use MeSH
- Angiotensin Receptor Antagonists pharmacology therapeutic use MeSH
- Diabetes Mellitus, Type 2 drug therapy MeSH
- Diabetic Cardiomyopathies drug therapy MeSH
- Enalapril pharmacology therapeutic use MeSH
- Drug Combinations MeSH
- Glycated Hemoglobin drug effects MeSH
- Insulin therapeutic use MeSH
- Humans MeSH
- Prospective Studies MeSH
- Heart Failure drug therapy physiopathology MeSH
- Tetrazoles pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
