Overview
LCZ696 is a linked molecule consisting of Valsartan, an angiotensin receptor blocker, and a neutral endopeptidase inhibitor, which increases natriuretic peptides, leading to reduced blood pressure among other benefits. The PARADIGM-HF study studied patients with heart failure and reduced ejection fraction (HFrEF) in comparison with enalipril, an ACE inhibitor. The study was just closed early, as LCZ696 increased time to first occurrence of either cardiovascular death or heart failure hospitalization, though details have not been released. We surveyed 10 US Cardiologists to get a preview of how they would use LCZ696 under different assumptions about what the study found.
Question 1:
Assume LCZ696 reduced both cardiovascular deaths and hospitalizations.
In ALREADY treated HFrEF patients on ACE inhibitors or ARBs, what percent will you SWITCH to LCZ696, if the reduction
in CV deaths and hospitalizations was by the following amounts?
Question 2:
Assume LCZ696 reduced both cardiovascular death and hospitalizations.
In NEW HFrEF patients not yet on ACE inhibitors or ARBs, what percent will you START on LCZ696, if the reduction in CV
death and hospitalizations was by the following amounts?
Question 3:
Assume LCZ696 only reduced hospitalizations, and not cardiovascular death.
In ALREADY treated HFrEF patients on ACE inhibitors or ARBs, what percent will you SWITCH to LCZ696, if the reduction
was by the following amounts?
Question 4:
Assume LCZ696 only reduced hospitalizations, and not cardiovascular death.
In NEW HFrEF patients not yet on ACE inhibitors or ARBs, what percent will you START on LCZ696, if the reduction was by
the following amounts?
Question 5:
Assume LCZ696 only reduced cardiovascular death, and not hospitalizations.
In NEW HFrEF patients not yet on ACE inhibitors or ARBs, what percent will you START on LCZ696, if the reduction was by
the following amounts?