Patients taking sacubitril/valsartan to treat heart failure may experience survival benefit

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 - Heart Failure - Don't use until 3/1/12

An actuarial analysis found that patients who receive sacubitril/valsartan may have an increased life expectancy and reduced risk of death from cardiovascular causes or hospitalization for heart failure compared with patients who take enalapril.

Lead researcher Brian Claggett, PhD, of Brigham and Women’s hospital in Boston, and colleagues published their results in the New England Journal of Medicine on Dec. 3.

In July, the FDA approved sacubitril/valsartan (Entresto, Novartis) to treat patients with heart failure and reduced ejection fraction. The drug is an oral medication taken twice daily.

The approval was based on results of the PARADIGM-HF trial, which included 8,442 patients. Patients who received sacubitril/valsartan had a significant reduction in the risk of cardiovascular mortality compared with those who received enalapril, which is a commonly used FDA-approved ACE inhibitor.

In this analysis, the researchers evaluated information on the age of randomization and the age at the time of an outcome event in the PARADIGM-HF trial and then estimated age-specific event rates and expected survival times.

They estimated that a 55 year old patient similar to those enrolled in the PARADIGM-HF trial would live an additional 1.3 years if they received sacubitril/valsartan. The projected life expectancy would increase an additional 11.6 years if they received enalapril and an additional 12.9 years if they received sacubitril/valsartan.

The 55 year old would have a mean benefit of 2.1 years in freedom from cardiovascular causes or hospitalization for heart failure.

In addition, a 65 year old patient similar to those enrolled in the PARADIGM-HF trial would live an additional 1.4 years if they received sacubitril/valsartan. The projected life expectancy would increase an additional 10.0 years if they received enalapril and an additional 11.4 years if they received sacubitril/valsartan.

The 65 year old would have a mean benefit of 1.6 years in freedom from cardiovascular causes or hospitalization for heart failure.

“The projected magnitude of treatment benefit was consistent across a wide range of patient ages (mean, 1 to 2 years of extended survival time with sacubitril–valsartan for patients who were 45 to 75 years of age),” the researchers wrote.