Gervasini Guillermo, Robles Nicolas Roberto
a Department of Medical and Surgical Therapeutics, Division of Pharmacology, Medical School , University of Extremadura , Badajoz , Spain.
b Service of Nephrology , Infanta Cristina University Hospital , Badajoz , Spain.
Expert Opin Investig Drugs. 2017 May;26(5):651-659. doi: 10.1080/13543784.2017.1317345. Epub 2017 Apr 21.
Patients with renal dysfunction are at a higher risk of cardiovascular disease (CVD), which often shares manifestations with heart failure (HF). Last year, the FDA approved the use of sacubitril-valsartan in patients with HF. This dual-acting agent enhances the functions of natriuretic peptides and inhibits the renin-angiotensin system. Areas covered: This review summarizes the existing preclinical and clinical studies carried out with sacubitril-valsartan (and other drugs with similar pharmacological mechanisms) in HF and hypertensive patients. We put the focus on the renal data provided by these studies. Data were obtained from English peer-reviewed articles on PubMed and clinical trials registered in ClinicalTrials.gov. Expert opinion: Overall, sacubitril-valsartan might be a promising therapeutic approach in patients with renal dysfunction. Renal conditions with marked CV risk, such as arterionephrosclerosis, could constitute a particular setting where to evaluate the impact of the drug. Nevertheless, large, randomized trials are needed to confirm the beneficial effects and safety profile of the drug in renal patients, as well as to elucidate some concerns observed in HF trials, such as the slight increase in proteinuria.
肾功能不全患者患心血管疾病（CVD）的风险更高，而心血管疾病往往与心力衰竭（HF）有共同表现。去年，美国食品药品监督管理局（FDA）批准了沙库巴曲缬沙坦用于心力衰竭患者。这种双重作用药物可增强利钠肽的功能并抑制肾素-血管紧张素系统。涵盖领域：本综述总结了在心力衰竭和高血压患者中使用沙库巴曲缬沙坦（以及其他具有类似药理机制的药物）进行的现有临床前和临床研究。我们重点关注这些研究提供的肾脏数据。数据来自PubMed上的英文同行评审文章以及ClinicalTrials.gov上注册的临床试验。专家意见：总体而言，沙库巴曲缬沙坦可能是治疗肾功能不全患者的一种有前景的方法。具有明显心血管风险的肾脏疾病，如动脉硬化性肾病，可能是评估该药物影响的特殊情况。然而，需要大型随机试验来证实该药物在肾病患者中的有益效果和安全性，以及阐明在心力衰竭试验中观察到的一些问题，如蛋白尿略有增加。
