New drug treatment for heart failure

Professor Rob Doughty talks about a new combination medicine to New Zealand for the management of congestive heart failure - ‘Entresto’ Sacubitril/ Valsartan. Rob is a cardiologist and holds the Heart Foundation Chair in Heart Health at the University of Auckland. He practices at Auckland City Hospital where he is the leader of the heart failure service and privately at the Auckland Heart group.

Topics

Introduction to this drug ‘Entresto’ Sacubitril/ Valsartan
What is a neprilysin inhibitor? What is its mechanism of action?
What is so special about the combination medicine?
What patients should we consider using Entresto in? Where does it fit in the treatment ladder?
What are the benefits to our patients of using this medication?
What is the starting dose and how is it titrated?
Are there populations that need to be started more slowly?
What other considerations (paediatrics, pregnant or breastfeeding women)?
Red flags for urgent referral
Side effects to warn patients about
Drug interactions to be aware of.

Take home messages

Entresto is a medication for the treatment of patients with symptomatic heart failure with reduced ejection fraction.
It requires careful consideration in terms of dose introduction, titration and monitoring.
There are many important interactions and multiple common side effects- be aware of these and provide the patient with a consumer medicine information sheet.
If angioedema is suspected- stop the medicine immediately and speak to a cardiologist.