Bareiss P, Ohlmann P, Roul G
Service de cardiologie, hôpital de Hautepierre, avenue Molière, hôpitaux universitaires de Strasbourg, 67098 Strasbourg.
Arch Mal Coeur Vaiss. 2002 Feb;95 Spec 4(5 Spec 4):51-3.
The morbidity and mortality of cardiac insufficiency remains such that it justifies the pursuit of finding new drugs and new sensitive techniques to slow or abolish its evolution. Bringing the vasopeptidases, such as omapatrilat, up to date results in a rational process aimed at simultaneously modulating certain interactive humoral systems. They represent drugs which simultaneously inhibit neutral endopeptidase and angiotensin converting enzyme with the effect of potentiating the natiuretic peptide system and bradykinin, and blocking the conversion of angiotensin I and angiotensin II. In the IMPRESS study, omapatrilat has been evaluated in patients with cardiac insufficiency versus lisinopril; there was no significant difference on the principal outcome measure which was exercise tolerance, however it was significantly more effective than lisinopril on the outcome measure combining death and hospital admission for deteriorating cardiac insufficiency. A wider study is underway, the OVERTURE study, which is evaluating omapatrilat versus enalapril on hospital admission and all-cause mortality. The Vanlev dossier has not yet been submitted to the regulatory authorities for obtaining its authorisation to be put on the market.
心脏功能不全的发病率和死亡率仍然很高，这使得寻找新药物和新的敏感技术来减缓或阻止其进展具有合理性。开发血管肽酶，如奥马曲拉，是一个旨在同时调节某些相互作用的体液系统的合理过程。它们代表了一类药物，能同时抑制中性内肽酶和血管紧张素转换酶，从而增强利钠肽系统和缓激肽的作用，并阻断血管紧张素I向血管紧张素II的转化。在IMPRESS研究中，对心脏功能不全患者使用奥马曲拉与赖诺普利进行了评估；在主要结局指标即运动耐量方面没有显著差异，然而在将死亡和因心脏功能不全恶化而住院这一结局指标上，奥马曲拉比赖诺普利显著更有效。一项更广泛的研究正在进行中，即OVERTURE研究，该研究正在评估奥马曲拉与依那普利在住院率和全因死亡率方面的差异。Vanlev的相关资料尚未提交给监管部门以获得上市许可。
