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ENTRESTO is indicated in adult patients for the treatment of symptomatic chronic heart failure with reduced ejection fraction.4,5 It is the first-in-class ARNI recommended for the treatment of chronic HFrEF and targets two essential pathways in a complementary manner.2,4,5
To learn more, review the GB and NI Summary of Product Characteristics.4,5
For patients living with chronic HFrEF, time is essential, so start Entresto first line as part of cornerstone treatment1–3,6
ARNI may be used first line as part of cornerstone HFrEF therapy with a BB, MRA and SGTL2i in the 2021 ESC guidelines for the treatment of chronic HFrEF patients.6
Even when patients do not exhibit apparent symptoms, cardiac damage is constantly occurring7
ENTRESTO has a dual MoA that simultaneously inhibits vasoconstriction and promotes vasodilation5
Improve chronic HFrEF patients’ quality of life vs ACEi (enalapril)9,12
National and international guidelines support ENTRESTO as a first line treatment option in chronic HFrEF*‡¶1–3,17,18
¶NICE and CaReMe UK recommendation for chronic HFrEF patients where ejection fraction is <35%.1,20
Support your patients on their heart failure treatment journey
MyEntresto is designed to:
- Reduce the burden of repeat appointments
- Boost understanding of heart failure
- Improve adherence to treatment leading to better patient outcomes19
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*CaReMe UK: sacubitril/valsartan is recommended as a first-line treatment option for chronic HFrEF where ejection fraction is <35%. Sacubitril/valsartan is to be given in combination with a beta-blocker and MRA. Measure serum sodium, potassium and assess renal function before and after starting, and after each dose increment. If eGFR is 30 to 45 ml/min/1.73 m2, consider lower doses or slower titration of ACEI/ARBs/sacubitril/valsartan or MRAs.1
†ESC: ARNI may be used first line as part of cornerstone HFrEF therapy with a BB, MRA and SGLT2i for the treatment of chronic HFrEF patients.2
‡ACC: ARNIs, ACE-inhibitors or ARBs are recommended as first-line therapy in patients with HFrEF to reduce morbidity and mortality. If patients have chronic symptomatic HFrEF with NYHA class II or III symptoms and they tolerate an ACEi or ARB, they should be switched to an ARNi because of improvement in morbidity and mortality.3
§DISCLAIMER: This is a US guideline and should not be used to guide treatment decisions in the UK.
ACC, American College of Cardiology; ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ARNI, angiotensin receptor neprilysin inhibitor; BB, beta-blocker; CaReMe UK, Cardio-Renal-Metabolic Partnership UK; ESC, European Society of Cardiology; HFrEF, heart failure with reduced ejection fraction; MoA, mode of action; MRA, mineralocorticoid receptor antagonist; NYHA, New York Heart Association; SGLT2i, sodium-glucose co-transporter 2 inhibitor.
References:
- CaReMe UK HF algorithm. Available at: https://www.britishcardiovascularsociety.org/__data/assets/powerpoint_do.... (Accessed May 2023).
- McDonagh TE, et al. Eur Heart J 2021;42(36):3599–3726.
- Heidenreich PA, et al. Circulation 2022;145:e895–e1032.
- ENTRESTO Summary of Product Characteristics. Electronic medicines compendium website, GB. Available at: https://www.medicines.org.uk/emc/product/7751/smpc. (Accessed May 2023).
- ENTRESTO Summary of Product Characteristics. Electronic medicines compendium website, NI. Available at: https://www.emcmedicines.com/en-gb/northernireland/medicine?id=a1393009-... (Accessed May 2023).
- Ponikowski P, et al. ESC Heart Fail 2014;1(1):4–25.
- Mann DL, Bristow MR. Circulation 2005;111(21):2837–2849.
- Claggett B, et al. N Engl J Med 2015;373(23):2289–2290.
- Lewis EF, et al. Circ Heart Fail 2017;10(8):e003430.
- McMurray JJ, et al. N Engl J Med 2014;371(11):993–1004.
- Solomon SD, et al. JACC Heart Fail 2016;4(10):816–822.
- Chandra A, et al. JAMA Cardiol 2018;3(6):498–505.
- Velazquez EJ, et al. N Engl J Med 2019;380(6):539–548.
- Desai AS, et al. JAMA 2019;322(11):1077–1084.
- Wachter R, et al. Eur J Heart Fail 2019;21(8):998–1007.
- Januzzi JL Jr, et al. JAMA 2019;322(11):1085–1095.
- Welsh HF Expert Reference Group 2021. HF in Wales in 2021 – a Parallel Approach.
- Heart Failure Hub Scotland guidelines. Available at: https://www.heartfailurehubscotland.co.uk/wp-content/uploads/2020/03/NHS-Scotland-Heart-Failure-Transition-and-Recovery-Plan-During-COVID-19-May-2020-Final.pdf. (Accessed May 2023).
- Aremu TO, et al. Pharmacy (Basel) 2022;10(5):106.
- NICE. Sacubitril valsartan for treating symptomatic chronic heart failure with reduced ejection fraction. Available at: https://www.nice.org.uk/guidance/ta388/chapter/1-Recommendations (Accessed July 2023).