A Meta-Analysis on the Effect and Safety of LCZ696 in the Treatment of Hypertension

Li Zheng; Binbin Xia; Xuqian Zhang; Yan Zhao

doi:10.1155/2021/8867578

March 20, 2021Cardiology Research and PracticeOpen Access

A Meta-Analysis on the Effect and Safety of LCZ696 in the Treatment of Hypertension

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Why the study?

The differences in effect and safety between LCZ696 and ARBs in the treatment of hypertension had not been systematically evaluated.

Does sacubitril/valsartan reduce blood pressure more effectively than ARBs in patients with hypertension?

Structured PICO

Does sacubitril/valsartan reduce blood pressure more effectively than ARBs in patients with hypertension?

P

Population

4,313 hypertensive patients pooled from 8 randomized controlled trials

I

Intervention

Sacubitril/valsartan (LCZ696)

C

Comparator

Angiotensin receptor blockers (ARBs)

O

Outcome

Reduction in systolic blood pressure (msSBP)surrogate

Sacubitril/valsartan provides superior blood pressure reduction compared to ARBs in hypertensive patients, though it is associated with an increased risk of cough.

Implication

Sacubitril/valsartan may be preferred over ARBs for hypertension; confirms greater msSBP reduction in pooled randomized data.

Abstract

Objectives. To systematically evaluate the differences in effect and safety of LCZ696 and angiotensin receptor blockers (ARBs) in the treatment of hypertension. Methods. We searched PubMed, Cochrane, Web of Science, and Ovid, collected randomized controlled trials (RCTs) about the effect and safety of LCZ696 and ARBs in hypertensive patients, extracted relevant data and evaluated the quality of the included literature according to the RCT quality evaluation standard recommended by Cochrane Reviewer’s Handbook, using RevMan 5.3, and performed meta-analysis. Results. Eight RCTs studies were included, with a total of 4313 patients. Compared with ARBs, LCZ696 can better reduce systolic blood pressure (msSBP) (WMD −4.29 mmHg; 95% CI: −5.37 to −3.21; P < 0.001), diastolic blood pressure (msDBP) (WMD −1.87 mmHg; 95% CI:−2.38 to −1.36; P < 0.01), ambulatory systolic blood pressure (maSBP) (WMD −3.37 mmHg; 95% CI:−4.26 to −2.47; P < 0.01), and ambulatory diastolic blood pressure (maDBP) (WMD −1.47 mmHg; 95% CI: −1.97 to −0.97; P < 0.01). In terms of safety, LCZ696 is basically the same as ARBs, but LCZ696 is more likely to cause cough than ARBs (OR = 2.38; 95% CI: 1.27 to 4.47; P < 0.01). Conclusion. LCZ696 can significantly reduce the blood pressure level of patients with hypertension, but it is necessary to pay attention to whether the patient will experience coughing after taking the drug.