The use of sacubitril/valsartan in anthracycline-induced cardiomyopathy: A mini case series
- 27 June 2018
- journal article
- research article
- Published by SAGE Publications in Journal of Oncology Pharmacy Practice
- Vol. 25 (5), 1231-1234
- https://doi.org/10.1177/1078155218783238
Abstract
Sacubitril/valsartan has been shown to significantly reduce cardiovascular mortality and hospitalizations due to heart failure in adult patients with reduced ejection fraction when compared to enalapril. To the best of our knowledge, the combination of sacubitril (neprilysin inhibitor) and valsartan (angiotensin receptor blocker) has not been evaluated in patients with chemotherapy-induced cardiomyopathy, as these patients were excluded from the recent pivotal trial, PARADIGM-HF. However, current guidelines for the evaluation and management of cardiovascular complications of cancer therapy, published by the Canadian Cardiovascular Society, direct clinicians to the Canadian Cardiovascular Society Heart Failure Guidelines for the management of cancer patients who develop clinical heart failure or an asymptomatic decline in left ventricular ejection fraction (e.g. >10% reduction from baseline or left ventricular ejection fraction <53%), which could include the use of sacubitril/valsartan. Retrospective descriptive comparative case study of two patients treated with sacubitril/valsartan. We present data from two patients who experienced anthracycline-induced cardiomyopathy and were successfully managed with sacubitril/valsartan after suboptimal responses to traditional evidence-based heart failure therapies. Both patients demonstrated some recovery of function and normalization of N-terminal pro B-type natriuretic peptide levels. Sacubitril/valsartan was well tolerated with minimal side effects. To date, neither patient has required hospitalization or additional clinic interventions for heart failure. While further large scale studies are required to determine a comprehensive safety and efficacy profile, we report two cases of anthracycline-induced cardiomyopathy survivors managed with sacubitril/valsartan with minimal side effects and no hospitalizations.Keywords
This publication has 9 references indexed in Scilit:
- 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice GuidelinesEuropean Heart Journal, 2016
- Canadian Cardiovascular Society Guidelines for Evaluation and Management of Cardiovascular Complications of Cancer TherapyCanadian Journal of Cardiology, 2016
- Current views on anthracycline cardiotoxicityHeart Failure Reviews, 2016
- The Canadian Cardiovascular Society Heart Failure Companion: Bridging Guidelines to Your PracticeCanadian Journal of Cardiology, 2015
- The prevention, detection and management of cancer treatment-induced cardiotoxicity: a meta-reviewBMC Cancer, 2015
- Angiotensin–Neprilysin Inhibition versus Enalapril in Heart FailureNew England Journal of Medicine, 2014
- Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin‐converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM‐HF)European Journal of Heart Failure, 2013
- Prevention of High-Dose Chemotherapy–Induced Cardiotoxicity in High-Risk Patients by Angiotensin-Converting Enzyme InhibitionCirculation, 2006
- Use of Chemotherapy plus a Monoclonal Antibody against HER2 for Metastatic Breast Cancer That Overexpresses HER2New England Journal of Medicine, 2001