A recent study published in the Journal of Pharmacy Practice aimed to identify risk factors for intolerance in hospitalized patients initiated on sacubitril/valsartan.

Sacubitril/valsartan is currently approved by the Food and Drug Administration to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction (HFrEF). The treatment combines a neprilysin inhibitor with an angiotensin II receptor blocker. 

This retrospective, single-center study included 143 patients who were newly initiated on sacubitril/valsartan during their hospitalization. To investigate the primary outcome of risk factors for intolerance (defined as being newly initiated while hospitalized but not discharged with the drug), the study authors compared the demographics between those who were able to tolerate sacubitril/valsartan and those who could not.  

Results showed that of the total number of patients included in the study, 20.3% (n=29) were intolerant to inpatient initiation of sacubitril/valsartan; among these patients, hypotension was found to be the primary reason for intolerance (65.5%). While comparing patient characteristics showed that those with newly diagnosed heart failure were more likely to tolerate treatment initiation, “no other differences between groups were identified among potential predictors for intolerance to sacubitril/valsartan initiation, including [systolic blood pressure], age, gender, [acute decompensated heart failure], [serum creatinine], or serum potassium,” the authors reported.


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Based on their findings, the authors concluded that sacubitril/valsartan may be safety initiated in hospitalized patients as the majority appeared to tolerate the drug. However, they added that more research is needed to better determine “ideal candidates for inpatient sacubitril/valsartan initiation.”

For more information visit journals.sagepub.com.