MTRAC issues commissioning guidance for sacubitril/valsartan (Entresto) for the treatment of heart failure

The Committee has issued a series of considerations for commissioners when making decisions about the use of sacubitril-valsartan for heart failure. It is based on evidence from the PARADIGM-HF study.

In DRAFT guidance (issued March 2016), NICE recommends sacubitril-valsartan as an option for treating symptomatic chronic heart failure with reduced ejection fraction, only in people with New York Heart Association (NYHA) class II to IV symptoms and with a left ventricular ejection fraction of 35% or less, and who are already taking a stable dose of angiotensin-converting enzyme inhibitors or angiotensin II receptor-blockers.

The DRAFT guidance further advises that treatment with sacubitril-valsartan should be started by a heart failure specialist with access to a multidisciplinary heart failure team. Dose titration and monitoring should be performed by the most appropriate team member as defined in NICE’s guideline on chronic heart failure in adults: management.