The Novel Antihypertensive – ANRI Combination of sacubitril/valsartan, Lowers HbA1c in Diabetes Patients

In the recent issue of The Lancet Diabetes and Endocrinology, a post-hoc analysis of PARADIGM-HF has shown that sacubitril/valsartan (EntrestoR, Novartis) displayed significant reductions in HbA1c in diabetes subjects when compared to people with diabetes in the enalapril control group.

Results of the PARADIGM-HF trial was published in The New England Journal of Medicine in September 2014. The trial demonstrated that the novel angiotensin receptor/neprilysin inhibitor (ANRI) combination of sacubitril/valsartan (EntrestoR, Novartis) was superior to enalapril in reducing the risk of cardiovascular death or hospitalization for worsening heart failure with reduced ejection fraction. Neprilysin is a naturally occurring endopeptide responsible for degradation of naturetic peptides and vasoactive peptides (angiotensin, bradykinin, and adrenomedulin).

Though the drug was approved by the FDA in July 2015, because of the cost associated with EntrestoR the drug didn't take off. PARAGON-HF trial is also underway which will further clarify the outcomes observed in PARADIGM-HF trial. This trial will be comparing the efficacy of sacubitril/valsartan vs valsartan alone in heart failure with preserved ejection fraction.

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