Neprilysin Inhibition in Heart Failure with Reduced Ejection Fraction: A Clinical Review.

There has been a 10-year hiatus in the approval of a new pharmacotherapy for patients with chronic heart failure with a reduced ejection fraction ( HFr EF). Combining an angiotensin receptor blocker, valsartan, with sacubitril, an inhibitor of neprilysin, results in increasing levels of natriuretic peptides that counterbalance high circulating levels of neurohormones in HFr EF. This has resulted in the development of a new agent, LCZ696. A comprehensive overview of LCZ696, its pharmacology, its role in the pathophysiology of HFr EF, completed and future clinical trial information, specific critical issues, and the place of LCZ696 in HFr EF therapy are presented. [ABSTRACT FROM AUTHOR]