Angiotensin receptor-neprilysin inhibition with LCZ696: a novel approach for the treatment of heart failure

The natriuretic peptide system exerts beneficial cardiorenal effects in chronic heart failure, whereas activation of the renin–angiotensin–aldosterone system exerts opposing and deleterious effects. LCZ696, a first-in-class angiotensin receptor neprilysin inhibitor, targets both neurohormonal systems by inhibiting neprilysin, which prevents natriuretic peptide degradation, while concomitantly blocking the angiotensin (AT 1 ) receptor. In clinical studies of patients with chronic heart failure with reduced and preserved left ventricular ejection fraction, LCZ696 has been shown to improve biomarkers of cardiorenal function. The effects of LCZ696 on cardiovascular outcomes and survival in patients with heart failure are currently being investigated.