Current medical research and opinion
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We evaluated the clinical efficacy of sacubitril/valsartan in a group of ambulatory patients with heart failure (HF) with reduced ejection fraction (HFrEF) referred to our HF clinic. ⋯ Based on our real-life experience, in HFrEF patients with NYHA class II-III, the new angiotensin receptor-neprilysin inhibitor (ARNi) sacubitril/valsartan was effective in improving HF management, both from the clinical and the echocardiographic perspective.
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Severe diarrhea-predominant irritable bowel syndrome (IBS-D) is associated with decreased health-related quality of life (HRQOL) and increased health care costs. Treatment recommendations for IBS-D often start with traditional pharmacotherapy (TP), with escalation to alosetron, rifaximin or eluxadoline if there is no success. There has been no previous head-to-head clinical trial comparing IBS-D treatment outcome for alosetron versus TP. This study, GSK protocol S3B30020, evaluated resource use, work productivity, health-related quality of life and global symptom response in women with IBS-D who were treated with alosetron or TP. ⋯ Alosetron 1 mg BID significantly reduced health care utilization and lost productivity, and significantly improved global IBS symptoms, HRQOL, and participation in outdoor and social activities compared with treatment response to TP.
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To describe the characteristics of patients treated with the capsaicin 8% patch, prescribing conditions, long-term effects of repeat treatment on pain intensity and perception, quality of life, and impact on concomitant medication. ⋯ The data of this post-marketing study meets the request by the French authorities for additional data on conditions of use in everyday practice. They confirmed the tolerance and long-term effect of capsaicin 8% patch in patients with peripheral neuropathic pain in real-world conditions.
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Case Reports
Sacubitril/valsartan can improve exercise performance in systolic chronic heart failure patients: a case report.
The cardiopulmonary exercise test (CPET) provides functional prognostic parameters for patients with chronic heart failure (CHF), such as peak volume of oxygen (VO2) and minute ventilation/carbon dioxide production (VE/VCO2) slope. Sacubitril/valsartan (LCZ696) has been recently approved for CHF patients as it reduces cardiovascular (CV) deaths and hospitalization for heart failure (HF). However, the potential beneficial effects of this therapy on exercise performance have been poorly investigated to date. ⋯ We present a case of a systolic HF patient successfully treated with sacubitril/valsartan who showed a rapid improvement of exercise performance at CPET.
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Case Reports
Management of a patient with heart failure by sacubitril/valsartan: improvement of functional capacity.
The main objectives of the treatment of heart failure (HF) are to improve patient clinical status, functional capacity and quality of life, as well as reducing re-hospitalization rate and mortality. A new compound, consisting of an angiotensin-receptor blocker (ARB) (valsartan) and a neprilysin (NEP) inhibitor (sacubitril), belonging to the newly established class of angiotensin receptor-neprilysin inhibitors (ARNIs) showed marked efficacy, without any relevant safety issue, in the treatment of patients with HF. ⋯ Therapy with sacubitril/valsartan was initiated after some years of other treatments, which did not lead to any positive outcome in HF, quality of life and clinical functions. After only 1 month of sacubitril/valsartan therapy, the patient reported a significant improvement in quality of life, and in 6 months his NYHA class switched from III to I.