Background Sacubitril-valsartan (SV) is a new drug association for chronic symptomatic heart failure (HF) with altered left ventricular ejection fraction (LVEF). Since January 2016, three different strengths (24/26 mg, 49/51 mg, 97/103 mg) are available in hospital pharmacies only.
Purpose The main objective is to assess the conformity of SV prescriptions in clinical practice, in agreement with its summary of product characteristics (SPC), after 1 year on the market. The second aim is to evaluate the patients’ compliance and quality of life (QoL).
Material and methods Patients who received SV at our hospital’s dispensing desk from 1 January 2016 to 30 June 2017 are included. SPC conformity is evaluated only for the prescriptions initiated in our hospital. Compliance is measured by the medication possession ratio (MPR) for the patients receiving SV for more than 3 months. QoL is evaluated with the Minnesota Living with Heart Failure Questionnaire, for the patients who came at the hospital’s dispensing desk from June 2017 to September 2017.
Results Fifty-two patients are included, sex ratio M/F 5, average age 64±15 years. Thirty-five treatments were initiated by our hospital’s physicians: 94% by cardiologists and 6% following cardiologic advice. In accordance with the SPC, no patient presented any contraindication. Sixty-nine per cent and 20% of the patients were previously treated by angiotensin-converting-enzyme inhibitor and angiotensin II receptor blockers respectively. All patients had a glomerular filtration rate >30 mL/min. But SV is non-indicated for five patients (LVEF >35%). Moreover, the initial dose was given according to the SPC for only 28 patients, 17 patients had no titration to the target dose and 13 patients had a follow-up with a brain natriuretic peptide rate measurement.
Compliance has been evaluated for 43 patients. It is optimal (MPR ≥100%) for 19 patients and poor for 16 patients (MPR <80%).
QoL measured for 14 patients, averaged 27±16, which seems to be better than in the general HF population: 63.7±2.30.1
Conclusion SV is prescribed in the right indication, but the initiation dose’s choice, its subsequent titration and the biological follow-up can be improved. Despite a low compliance, SV might help to strongly improve the QoL of HF patients.
Reference and/or Acknowledgements 1. Alla F. Self-rating of quality-of-life provides additional prognostic information in heart failure. Eur J Heart Fail2002;4:337–343.
No conflict of interest
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