"Initiating sacubitril/valsartan (LCZ696) in heart failure: result of TITRATION, a double-blind, randomized comparison of two uptitration regimens"

Autore: Senni M. et al. Articolo ricevuto dal dott. Franco Cosmi, co-autore dell'articolo pubblicato su European Journal of Heart Failure 18:1193-1202,2016

The Prospective comparison of angiotensin receptor neprilysin inhibitor (ARNI) with angiotensin-converting enzyme inhibitor (ACEI) to Determine Impact on Global Mortality and morbidity in Heart Failure (PARADIGM-HF) trial established the safety and tolerabilityofthetargetdoseoftheARNIsacubitril/valsartan(200mg twice daily), also known as LCZ696, in ambulatory patients with chronicheartfailurewithreducedejectionfraction(HFrEF)already treatedwithanACEI/angiotensinreceptorblocker(ARB).Thetrial included a single-blind active run-in period, during which tolerability to both enalapril and sacubitril/valsartan was assured prior to randomisation.1,2 During the PARADIGM-HF run-in, patients transitioned from enalapril 10mg twice daily to sacubitril/valsartan 100mg (sacubitril 49mg and valsartan 51mg) twice daily and then sacubitril/valsartan 200mg (sacubitril 97mg and valsartan 103mg) twice daily over a 6–8week period before randomisation.