Practical guidance on the use of sacubitril/valsartan for heart failure

Andrew J. Sauer, Robert Cole, Brian C. Jensen, Jay Pal, Nakul Sharma, Amin Yehya, Justin Vader

Research output: Contribution to journalReview article

3 Scopus citations

Abstract

Sacubitril/valsartan is a first-in-class angiotensin receptor-neprilysin inhibitor (ARNI) that has been recommended in clinical practice guidelines to reduce morbidity and mortality in patients with chronic, symptomatic heart failure (HF) with reduced ejection fraction (HFrEF). This review provides an overview of ARNI therapy, proposes strategies to improve the implementation of sacubitril/valsartan in clinical practice, and provides clinicians with evidence-based, practical guidance on the use of sacubitril/valsartan in patients with HFrEF. Despite evidence demonstrating the benefits of ARNI therapy over standard of care, only a fraction of eligible patients takes sacubitril/valsartan. Barriers preventing the prescription of sacubitril/valsartan in eligible patients may include practitioners’ unfamiliarity with ARNIs, safety concerns, and payer reimbursement issues. The optimal implementation of sacubitril/valsartan in clinical practice has the potential to reduce the overall burden of HF. Throughout this review, we describe our experience with sacubitril/valsartan, including strategies for the management of adverse events and common patient concerns. In addition, a strategy for the gradual introduction of sacubitril/valsartan using a treatment sequence scheme is proposed.

Original languageEnglish
Pages (from-to)167-176
Number of pages10
JournalHeart Failure Reviews
Volume24
Issue number2
DOIs
StatePublished - Mar 15 2019

Keywords

  • Angiotensin receptor-neprilysin inhibitor
  • Cardiovascular
  • Heart failure
  • Reduced ejection fraction
  • Sacubitril/valsartan

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    Sauer, A. J., Cole, R., Jensen, B. C., Pal, J., Sharma, N., Yehya, A., & Vader, J. (2019). Practical guidance on the use of sacubitril/valsartan for heart failure. Heart Failure Reviews, 24(2), 167-176. https://doi.org/10.1007/s10741-018-9757-1