A new analysis for heart failure drug Entresto revealed novel insights for managing diabetes when compared to an older medication.
Investigators found that Entresto could lower HbA1C, the standard metric used by physicians to gain an estimate of average glucose levels, better than the ACE-inhibitor enalapril in 3,778 reduced ejection fraction heart failure patients diagnosed with diabetes. These findings emerged from a larger randomized double-blind study called PARADIGM-HF, which was evaluating the safety and efficacy of Entresto against enalapril in 8,442 patients.
“The PARADIGM-HF trial studies patients with heart failure and reduced ejection fraction – approximately 40% of these patients had known diabetes or were diagnosed with diabetes at the time of enrollment,” explained Dr. Scott Solomon, M.D., the lead researcher and head of noninvasive cardiology at Brigham and Women’s Hospital to Drug Discovery & Development over email adding that his team focused on patients with an established diabetes diagnosis or individuals with previously unknown diabetes.
The investigators compared Entresto and Enalapril’s impact on HbA1C levels over a three-year period while also evaluating the rate of patient’s initiating insulin therapy to help deal with their condition.
Overall, the results from the first year indicated Entresto was able to reduce these levels by 0.26 percent compared to 0.16 percent for the enalapril arm while Entresto was also able to consistently keep these low levels throughout the observation period.
Furthermore, an estimated 29 percent fewer patients in the Entresto arm had to initiate insulin therapy in order achieve this level of control.
“Patients with heart failure and diabetes have significantly increased risk for heart failure hospitalizations and mortality. Some diabetes drugs have been shown to increase risk of heart failure. Moreover, patients who require more diabetes drugs appear to be at higher risk for adverse outcomes. Our findings suggest that use of sacubtril/valsartan (Entresto) rather than an ACE inhibitor can improve glycemia and might be associated with less use of anti-diabetic drugs, including insulin,” continued Solomon elaborating on these findings.
The next move for Novartis could be altering the way it analyzes data from these follow-up Entresto studies so it can look more closely at the medication’s glycemic control abilities, according to FiercePharma.
This new data could help Novartis increase access to Entresto as it has struggled to gain traction since its official launch in 2015. Payers have been hesitant to open up reimbursement plans for the drug due to factors like the cost and generic competition despite study results that indicated Entresto could prevent expensive hospitalizations.
Research and consulting firm GlobalData released a report last year predicting that the market for heart failure drugs would grow an estimated 13.7 percent reaching $3.2 billion with Entresto being the primary driver of this uptick.
Solomon’s team presented these results on March 18 in Washington D.C. at the annual American College of Cardiology meeting.
Filed Under: Drug Discovery