‘Novartis’ Entresto can lower readmission and fatality’

Lee Han-soo  Published 2018.12.07  17:39  Updated 2018.12.07 17:39


A local heart failure expert said Friday that Novartis’ Entresto, a chronic heart failure (HFrEF) treatment, can significantly help patients avoid readmission and fatality in a news conference Thursday.

Professor Woo Byung-soo from the Severance Christian Hospital explains the need to use Entresto as an initial treatment for patients suffering from heart failure during a news conference at Seoul Square, on Friday.

Professor Woo Byung-soo from the Severance Christian Hospital argued that patients with HFrEF should start taking Entresto as soon as possible to reduce readmission and mortality.

"Patients who are discharged after hospitalization due to HFrEF are in fragile condition,” Professor Woo said. “Therefore, the risk of readmission for the patient due to additional heart failure is very high.”

However, Entresto offers the advantage of pre-discharge initiation with superior treatment benefits over existing drugs at the vulnerable stage in patients with acute heart failure, he added. Novartis has recently revealed such advantages in its PIONEER-HF trial for Entresto.

The results showed that the company’s drug provided superior benefit compared to enalapril-a, a heart failure medication commonly used in patients with HFrEF, in treating patients who had been stabilized following admission for an acute decompensation heart failure (ADHF) event.

An Entresto patient group had a 29 percent greater reduction in the time-averaged N-terminal pro-B-type natriuretic peptide (NT-proBNP) at the fourth and eighth week compared to enalapril patients. The company saw significant decreases in NT-proBNP in Entresto patients as early as the first week after treatment started.

Novartis also confirmed similar results in patients who were diagnosed with heart failure after hospitalization with acute heart failure, patients without ACEi / ARB treatment, and African Americans.

In a pre-specified exploratory analysis of PIONEER-HF, Entresto also showed a significant 46 percent reduction in the risk of a composite of death, heart failure re-hospitalization, the need for left ventricular assist device (LVAD) insertion or listing for cardiac transplantation compared to enalapril over the eight-week treatment period.

“Such benefits have raised the need for the treatment as an early treatment for HFrEF patients,” Professor Woo said.

As of now, the government only reimburses the treatment in patients with chronic heart failure and reduced ejection fraction 35 percent or lower who have received angiotensin-converting-enzyme inhibitor (ACE) inhibitor or an angiotensin II-receptor antagonist but had little effect for over four weeks.

“Entresto has reduced biomarkers and re-admission rates compared to existing drugs, and the need for using the drugs in an earlier stage is on the rise,” he said. “Therefore, I believe the recent clinical trial result will affect guidelines and insurance benefits for using Entresto as an initial treatment regardless of whether the patient has taken an ACE inhibitor angiotensin II-receptor antagonist.”

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