Angiotensin receptor-neprilysin inhibitor treatment in people with chronic obstructive pulmonary disease and heart failure

While renin-angiotensin system inhibitors (RASi) have shown benefits for people with both heart failure (HF) and chronic obstructive pulmonary disease (COPD), limited data exists on the use of angiotensin receptor-neprilysin inhibitors (ARNIs) in this population. This study compares the effectiveness of RASi and ARNIs in people with coexisting COPD and HF. We identified individuals who started treatment with either ARNI or RASi since August 1, 2015. We assessed outcomes such as COPD exacerbations, acute respiratory failure, and lower respiratory tract infections (LRTIs) over 30 days to 3 years. Kaplan-Meier survival analysis and Cox regression models were applied to estimate survival probabilities and hazard ratios (HR). Among 9,071 ARNI users and 71,836 RASi users, the ARNI group has fewer respiratory complications. The ARNI group has a higher proportion of females compared to the RASi group (38.2% vs. 31.5%). Specifically, ARNI users have a lower incidence of COPD exacerbations (13.1% vs. 18.7%; HR, 0.84), acute respiratory failure (16.2% vs. 22.0%; HR, 0.90), and LRTIs (16.9% vs. 22.9%; HR, 0.91). In people with both COPD and HF, ARNI treatment is associated with fewer respiratory complications compared to RASi. People who have both heart failure (HR) and chronic obstructive lung disease (COPD) often experience serious breathing problems. Medicines called RAS inhibitors (RASi) have been used to help people with HR and COPD. However, a newer type of medicine, called angiotensin receptor-neprilysin inhibitors (ARNIs), has also shown therapeutic potential. The current study looked at patient outcomes using data from adults who had started either medication, tracking their health over several years. People taking ARNIs had fewer instances of sudden worsening of COPD symptoms such as breathlessness and cough, less respiratory failure, and fewer lung infections than those taking RASi. This suggests that ARNIs could be a better choice for people with both HF and COPD. mlHsu et al. examine the effectiveness of Angiotensin Receptor-Neprilysin Inhibitors (ARNI) in individuals with Chronic Obstructive Pulmonary Disease (COPD) and heart failure. Findings reveal that ARNI treatment in people with both COPD and HF may lower the risk of COPD exacerbations, respiratory failure, and respiratory tract infections.