LCZ696 is a heart failure drug from Novartis that many observers think will gain FDA approval later this year and go on to become a blockbuster. Perhapsthe biggest obstacle to the drugs success is the fear that it might raise the risk of Alzheimers disease. Now a new article in a top cardiology journal lays out the detailed basis for this concern. The authors donot contend that the Alzheimers issue will likely ruin the drugs chances, but they do maintain that the problem needs to be carefully monitored. I spoke with Milton Packer, the co-principal investigator of PARADIGM-HF, the mega trial that set off the mega excitement about the drug last year. He offers several persuasive arguments that Alzheimers disease wont bethe Achilles heel of LCZ696. But first lets look at the paper, published in theEuropean Heart Journal, by a group of French researchers. The paper focuses on the potential impact of sacubitril, which is one of the two key ingredients of LCZ696. Sacubitril inhibits the action of neprilysin. The French authors focus on two conflicting roles for neprilysin.The cardiovascular benefitsare achieved because in the heart neprilysin inhibition leads to increased levels of neuropeptides and vasodilators that are beneficial in … Continue reading
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