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Chronic heart failure: LCZ696 delays cardiovascular death and reduces heart failure hospitalizations versus Enalapril


Novartis has announced that the Data Monitoring Committee ( DMC ) unanimously recommended early closure of the PARADIGM-HF study, indicating patients with chronic heart failure with reduced ejection fraction ( HF-REF ) who received LCZ696 lived longer without being hospitalized for heart failure than those who received standard care with ACE-inhibitor Enalapril.
Based on the compelling efficacy and primary endpoint having been met, the trial will close early. This follows two previous interim analyses that showed the safety profile of LCZ696 was acceptable.

The finding that the treatment with LCZ696 was superior to currently recommended doses of Enalapril has profound implications for the care of patients with chronic heart failure.

LCZ696, a twice a day pill for heart failure, is a first in class medicine that acts in multiple ways on the neurohormonal systems of the heart, blocking receptors exerting harmful effects while simultaneously promoting protective mechanisms.
Known as an ARNI ( Angiotensin Receptor Neprilysin Inhibitor ) LCZ696 is thought to reduce the strain on the failing heart, promoting the ability of the heart muscle to recover.

PARADIGM-HF is a randomized, double-blind, phase III outcome study evaluating the efficacy and safety profile of LCZ696 versus Enalapril, an ACE inhibitor, in 8,436 patients with heart failure with reduced ejection fraction.
The primary outcome is a composite of time to first occurrence of either cardiovascular death or heart failure hospitalization, and the trial is also designed to be able to detect a significant difference in cardiovascular death.
The study was initiated in December 2009 and currently is the largest clinical trial in heart failure ever undertaken.

Chronic heart failure is a progressive, debilitating disease where the heart is unable to pump enough blood throughout the body. Symptoms such as breathlessness, fatigue and fluid retention can appear slowly and worsen over time, significantly impacting quality of life. Approximately half of patients have the reduced ejection fraction form of the disease.

Heart failure is a significant and growing public health concern with more 20 million people living with the disease across Europe and the US alone. It continues to be associated with high morbidity and mortality, frequent hospitalization and poor quality of life, despite currently available medicines. ( Xagena )

Source: Novartis, 2014

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