ace inhibitor + sacubitril + valsartan

The drug combination 'ace inhibitor + sacubitril + valsartan' refers to the investigational comparison of two cardioprotective regimens—an Angiotensin-Converting Enzyme (ACE) inhibitor (specifically enalapril) and the dual Angiotensin Receptor-Neprilysin Inhibitor (ARNI) sacubitril/valsartan (Entresto)—studied for the prevention of cancer therapy-related cardiac dysfunction (CTRCD). This specific regimen was evaluated in a Phase 2 clinical trial (NCT04092309) sponsored by the National & Kapodistrian University of Athens, focusing on adolescents and adults undergoing bone marrow transplantation (BMT) for hematological malignancies. The components work by inhibiting the renin-angiotensin-aldosterone system (via ACE inhibition and AT1 receptor blockade) and the neprilysin enzyme (via sacubitril), which collectively reduce cardiac strain and improve myocardial work indices. Although the trial compared these agents as separate arms, the combination of these mechanisms is a key area of research in cardio-oncology. It is important to note that in standard clinical practice, ACE inhibitors and sacubitril/valsartan are typically not administered concurrently due to a significantly increased risk of angioedema.

Brand names

Entresto

Other names

sacubitril/valsartan + enalaprilARNI + ACE inhibitor