Most Read Articles
Pearl Toh, 30 Mar 2018
Diagnosis of polycystic ovary syndrome (PCOS) is challenging, and there should be no rush to label an adolescent as having the condition before a thorough evaluation of symptoms, according to a leading endocrinologist who was speaking at the RCOG World Congress 2018 in Singapore.
Rachel Soon, 12 Dec 2018

A new ‘cooling’ drink product incorporating elements of traditional Chinese medicine (TCM) was launched in Kuala Lumpur recently.

Roshini Claire Anthony, 16 Apr 2019

Patients on the anticoagulant drug edoxaban could safely continue their treatment while undergoing certain procedures, with a low incidence of bleeding and cardiovascular events reported in the prospective EMIT AF/VTE* study.

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Most patients on ARNI do not receive full dose

10 Jan 2018

Most patients on the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan are started on the lowest dose and remain on the lowest or intermediate dose of the drug, data from primary care and cardiology practices in Germany have shown. [Wachter R, et al, AHA 2017, poster S5001]

Researchers retrospectively reviewed data from 1,095 primary care practices and 43 cardiology practices in Germany. The data set comprised a total of 1,643 patients prescribed sacubitril/valsartan, of whom 1,041 patients were from primary care practices and 692 were from cardiology practices.

Two-thirds of the patients (64 percent of the primary care cohort, 66 percent of the cardiology cohort) were started on the lowest dose of sacubitril/valsartan (26/24 mg BID). Among these patients, only 36 percent of those from the primary care cohort and 41 percent of those from the cardiology cohort had their sacubitril/valsartan dose up-titrated during a maximum follow-up period of 12 months. However, less than 11 percent of the patients received the target dose (103/97 mg BID) at the last recorded prescription.

Less than one-third of the patients (30 percent of the primary care cohort, 26 percent of the cardiology cohort) were initiated on the recommended starting dose of sacubitril/valsartan (51/49 mg BID). Among these patients, 24 percent of those from the primary care cohort and 36 percent of those from the cardiology cohort had their dose up-titrated to the target dose.

Only a small proportion (10 percent) of patients in each prescription group had their sacubitril/valsartan dose down-titrated.

Following the initiation of sacubitril/valsartan, the patients’ N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels decreased by approximately 30 percent (-503 pg/mL) – similar to the reduction observed in the PARADIGM-HF study.

Significant decreases in HbA1c (-0.3 percent; p<0.001) and systolic and diastolic blood pressure (-3.4 mm Hg and -1.6 mm Hg, respectively; p<0.001) were also observed following sacubitril/valsartan initiation. New York Heart Association class remained stable over time in the majority of patients.

“The effect of treatment with sacubitril/valsartan may have been greater if all patients had received the target dose,” the researchers suggested.

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Most Read Articles
Pearl Toh, 30 Mar 2018
Diagnosis of polycystic ovary syndrome (PCOS) is challenging, and there should be no rush to label an adolescent as having the condition before a thorough evaluation of symptoms, according to a leading endocrinologist who was speaking at the RCOG World Congress 2018 in Singapore.
Rachel Soon, 12 Dec 2018

A new ‘cooling’ drink product incorporating elements of traditional Chinese medicine (TCM) was launched in Kuala Lumpur recently.

Roshini Claire Anthony, 16 Apr 2019

Patients on the anticoagulant drug edoxaban could safely continue their treatment while undergoing certain procedures, with a low incidence of bleeding and cardiovascular events reported in the prospective EMIT AF/VTE* study.

06 Feb 2019
Depression symptoms in acne patients may improve following treatment with isotretinoin, according to a systematic review and meta-analysis.