| アブストラクト | BACKGROUND: Sacubitril/valsartan reduces the risk of hospitalizations and death among patients with heart failure (HF) with reduced ejection fraction; its use is poised to increase worldwide. As bradykinin is a substrate of neprilysin, angioedema was a theoretical concern potentiated by neprilysin inhibition. METHODS: We explored angioedema in clinical trials and real-world pharmacovigilance data. We conducted a trial-level random-effects meta-analysis of 5 RCTs studying the effects of sacubitril/valsartan in heart failure. FDA Adverse Event Reporting System (FAERS) provided real-world pharmacovigilance data in the US. RESULTS: The 5 trials enrolled 14,841 patients with follow-up ranging from 2 to 27 months. The collective rate of angioedema in RCTs was 0.5% in sacubitril/valsartan arms vs. 0.3% in control arms (pooled odds ratio of 1.35; 95% confidence interval - 0.45 to 4.1; P = .59) with moderate heterogeneity (I(2) 55.2.%). These relative effects were driven by the larger PARADIGM-HF and PARAGON-HF experiences. FAERS pharmacovigilance data identified 426 angioedema cases over the last 5 years out of 40,559 adverse events reported related to sacubitril/valsartan. CONCLUSIONS: Rates of angioedema with sacubitril/valsartan are reported to be low in RCTs and real-world clinical practice. |
|---|
| ジャーナル名 | International journal of cardiology |
|---|
| 投稿日 | 2020/8/26 |
|---|
| 投稿者 | Dani, Sourbha S; Ganatra, Sarju; Vaduganathan, Muthiah |
|---|
| 組織名 | Division of Cardiovascular Medicine, Lahey Hospital Medical Center, Burlington,;MA, United States of America; London School of Economics, Department of Health;Policy, London, UK. Electronic address: Sourbha.s.dani@lahey.org.;MA, United States of America.;Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School,;Boston, MA, United States of America. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/32841619/ |
|---|
