Assessing Hypotension Incidence and Dosing Strategies of Sacubitril/Valsartan in Real-World Heart Failure Management: Protocol for A Retrospective, Multicenter, Cohort Study (Preprint)

Author:

Jadhav Uday M,Mohanty Arun,Shah Jay,Chenniappan M,Krishna K. Naveen,Sattur Ameet G.,Mukhopadhyay Mainak

Abstract

BACKGROUND

The burden of heart failure (HF) and hypertension in India underscores the need for effective management strategies. Sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNi), has emerged as a pivotal therapy for HF with reduced ejection fraction (HFrEF). However, concerns about hypotension often hinder optimal dosing in clinical practice. The objective of this study is to observe the incidence of hypotension in HFrEF patients and to evaluate the best clinical practice to achieve an optimal tolerated dose of sacubitril/valsartan without treatment discontinuation.

OBJECTIVE

The primary aim of this study is to evaluate the incidence of hypotension among HFrEF patients receiving sacubitril/valsartan and assess the feasibility of dose titration to achieve optimal tolerated doses in real-world settings. Secondary objectives include evaluating treatment outcomes, tolerability, and factors influencing dosing adjustments.

METHODS

This is the protocol of a retrospective, multicenter cohort study aimed at assessing real-world usage patterns of sacubitril/valsartan among Indian HFrEF patients, focusing on hypotension occurrence and optimal dose attainment. Patients aged 18-80 years diagnosed with HFrEF (left ventricular ejection fraction (LVEF) ≤ 40%) and initiated on sacubitril/valsartan between November 2023 and May 2024 will be included. Baseline and follow-up data, including demographics, medical history, and treatment outcomes, will be analyzed using appropriate statistical tests. Data from approximately 150 healthcare facilities will be collected using a structured Case Report Form (CRF).

RESULTS

The study was initiated in February 2024. As of manuscript submission, 892 individuals have been recruited, with data collection expected to conclude by the end of May and results anticipated by June.

CONCLUSIONS

This study aims to contribute valuable insights into optimizing sacubitril/valsartan therapy for HFrEF patients in India, addressing concerns about hypotension and dosage optimization. The study seeks to inform clinical practice and enhance patient care by elucidating real-world usage patterns and outcomes

CLINICALTRIAL

Nil

Publisher

JMIR Publications Inc.

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