Effect of Sacubitril/Valsartan on Neurocognitive Function: Current Status and Future Directions.
Jason GaloDiego CelliRosario ColomboPublished in: American journal of cardiovascular drugs : drugs, devices, and other interventions (2020)
Sacubitril/valsartan is a new medication approved for the treatment of heart failure with reduced ejection fraction. While the drug failed to meet the primary endpoint in patients with heart failure with preserved ejection fraction in the PARAGON-HF trial, improvements were noted in several secondary endpoints. Valsartan is an angiotensin receptor blocker and sacubitril is a neprilysin inhibitor. Neprilysin is postulated to have a role in the degradation of beta-amyloid in the brain; therefore, sacubitril could theoretically increase beta-amyloid plaque deposition in the brain and potentially increase the risk of Alzheimer's disease. Although pre-clinical and clinical studies have shown promising safety results, those studies have been heavily criticized for short monitoring time and targeted populations. In accordance with the requirements of the US Food and drug Administration (FDA), the ongoing Prospective Evaluation of Cognitive Function in Heart Failure: Efficacy and Safety of Entresto compared to Valsartan on Cognitive Function in Patients with Chronic Heart Failure and Preserved Ejection Fraction (PERSPECTIVE; NCT02884206) multicenter, randomized, double-blinded trial is assessing the long-term neurocognitive effects and safety of sacubitril/valsartan, and results are expected in early 2022.
Keyphrases
- ejection fraction
- aortic stenosis
- heart failure
- drug administration
- phase iii
- current status
- phase ii
- double blind
- study protocol
- clinical trial
- open label
- white matter
- acute heart failure
- resting state
- bipolar disorder
- healthcare
- coronary artery disease
- placebo controlled
- angiotensin converting enzyme
- adverse drug
- cross sectional
- human health
- blood brain barrier
- cancer therapy
- brain injury
- subarachnoid hemorrhage
- combination therapy
- climate change
- drug delivery
- genetic diversity