Study On The Clinical Application Of Sacubitril/valsartan Sodium

Objective: To analyze the clinical application of sacubitril/valsartan sodium(LCZ696),evaluate the rationality of the application of LCZ696,formulate the drug management measures of LCZ696,and provide ideas for rational clinical drug use,improving effectiveness and safety,and achieving expected treatment benefits for patients.To investigate the clinical efficacy of LCZ696 in the treatment of Heart failure(HF)with Type 2 diabetes(T2DM),and to provide reference for the application of LCZ696 in HF with T2 DM.Methods: Medical records of HF patients treated with LCZ696 in outpatients and inpatients from January 2020 to June 2020 were collected and evaluated in terms of indications and contraindications,usage and dosage,drug conversion,target dose compliance rate,adverse reactions,etc.,to analyze and discuss the problems and rationality of clinical application.According to the investigation and analysis,the problems in the clinical application of LCZ696 were found,and the use standards,medication education and medication monitoring measures were formulated to provide reference for guaranteeing patients to achieve the expected treatment benefits.Patients with HF and T2 DM who were hospitalized in Chongqing Rongchang District People’s Hospital from June 2020 to June 2021 and met the inclusion and exclusion criteria were divided into control group and observation group.The control group was treated with other conventional HF and T2 DM basic treatment plus angiotensin converting enzyme inhibitor(ACEI)or angiotensin Ⅱ receptor blocker(ARB),The observation group was treated with other conventional HF and T2 DM basic treatment plus LCZ696,and the two groups were followed up for 12 weeks.The clinical efficacy,N-terminal pro-B type natriuretic peptide(NT-pro BNP),left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),fasting blood glucose(FBG),glycosylated hemoglobin(Hb A1c)and adverse reactions were evaluated,SPSS 23.0 was used for statistical analysis,and the difference was statistically significant(P<0.05).Results: A total of 117 medical records were collected,and the results showed that the proportion of drug use without indications was 26.5%,the proportion of relative contraindications was 6.84%,the proportion of irrational initial dose was 5.98%,the proportion of irrational administration frequency was6.84%,the proportion of dose reaching the treatment target was 53.84%,and the proportion of irrational drug conversion was 9.40%.The proportion of adverse reactions was 10.25%,which was reasonable in combination with other HF drugs.A total of 92 patients were collected,46 in the control group and 46 in the observation group.The results showed that after 12 weeks of treatment,the overall effective rate of LCZ696 treatment group was significantly higher than that of the control group(P<0.05),and the improvement of LCZ696 on NT-pro BNP,FBG,LVEF and LVEDD was more significant(P<0.05);The difference of Hb A1 c between the two groups after treatment was not statistically significant(P>0.05);There was no significant difference in the incidence of adverse reactions between the two groups at 12 weeks of treatment(P>0.05).Conclusion: The investigation and analysis found that the clinical application of LCZ696 has the problems of inappropriate indications,contraindications,inappropriate usage and dosage,target dose not reaching the standard,and unreasonable drug conversion,so as to prompt the rationality of clinicians’ prescription,point out the direction for clinical pharmacists to provide pharmaceutical care and formulate drug management measures,and ensure the expected clinical treatment benefits.For patients with HF complicated with T2 DM,compared with ACEI and ARB of traditional anti-HF drugs,the new anti-HF drug LCZ696 can better improve the symptoms,signs and cardiac function of patients,and may play a positive role in the improvement of blood glucose.