DUAL NEPRILYSIN AND AT1-ANGIOTENSIN RECEPTOR BLOCKADE: A NOVEL APPROACH FOR ANTIHYPERTENSIVE AND NEPHROPROTECTIVE THERAPY

Abstract

The review presents data on the role of natriuretic peptides in the pharmacodynamics of LCZ696 (sacubitril/valsartan) and the results of clinical studies evaluating its clinical efficacy in patients with arterial hypertension (HTN), including those with impaired renal function. LCZ696 when administered as monotherapy at doses 200–400 mg/day for 8 weeks causes a clinically significant antihypertensive effect in patients with essential HTN 1–2 degree, as well as when used in combination therapy in HTN 3 degree. Short-term use of the drug is not accompanied by angioedema occurrence or other side effects. These results apply mainly to patients with primary HTN with relatively preserved kidney function and without diabetes mellitus, as subjects with serum creatinine > 133 micromole/L and patients with type 1 and 2 diabetes mellitus were excluded. Available data show that LCZ696 at doses 200–400 mg/day for 8 weeks also provides obvious antihypertensive effect and a moderate decrease in albuminuria in patients with HTN 1–2 degree and chronic kidney disease 3–4 stage. The long-term, large-scale clinical trials are needed for a more complete assessment of the clinical efficacy and safety of LCZ696 in hypertensive patients, including patients with impaired renal function.