Why the study?
Do vasopeptidase inhibitors provide clinical benefit over ACE inhibitors in patients with heart failure?
Do vasopeptidase inhibitors provide clinical benefit over ACE inhibitors in patients with heart failure?
Vasopeptidase inhibitors have not demonstrated a clear clinical benefit over standard ACE inhibitors for the treatment of chronic heart failure.
No proven benefit of vasopeptidase inhibitors over ACE inhibitors in chronic heart failure; leaves open whether dual inhibition merits further targeted trials.
Considerable attention has recently focused on the vasopeptidase inhibitors (VPI), a new class of drug that combines angiotensin-converting enzyme (ACE) inhibitor activity with inhibition of natriuretic peptide breakdown. In theory, a drug with these properties may be beneficial both in hypertension and in heart failure. Whilst the efficacy of VPIs in hypertension has been consistently demonstrated in pre-clinical and clinical studies, the role of VPIs, if any, in heart failure is less clear, since numerous small studies have produced conflicting results. Furthermore, preliminary results from the recently completed Omapatrilat Versus Enalapril Randomised Trial of Utility in Reducing Events (OVERTURE) study have failed to establish the VPI, omapatrilat, as a first line therapy in the treatment of chronic heart failure. We review the literature on VPIs in heart failure and discuss possible reasons for the reported lack of benefit over ACE inhibitors.
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Dawson et al. (2002) studied this question.
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