Bismillah, alhamdulillah:  this was an interesting podcast talking about a new medication which combines Sacubitril a prodrug that is a Neprilysin inhibitor with Valsartan and one of the latest trials for patients with heart failure.

The DTB team noted that this was a multicenter trial showing benefit for the new drug, but there were some interesting caveats. The trial was comparing the new medication with enalapril 10 milligrams twice daily. Thus it is unclear  if this was actually showing a drug effect or a dose effect. The subgroup analysis show that this medication was actually not useful i.e. it was not any better than enalapril when used for patients who are over 75 or white Caucasian patients. The number needed to treat to prevent one extra cardiovascular death was around 30. The interesting thing was that it did not actually help patients feel any better who had heart failure so the patient symptom scores were exactly the same in both arms. 

Another thing they looked at was the concept of the de-prescribing. Quality is usually defined traditionally by the number of medications that have been started i.e. prescribed. De-prescribing or stopping medication is not taken into account. Overall a very interesting DTB podcast and very well worth listening to I hope you enjoy it.
June 2016: Problems with botanicals; a new drug for heart failure; frailty and deprescribing
DTB podcast
Duration: 19:42
Published: Wed, 25 May 2016 10:52:46 +0000

In this podcast, James Cave (DTB Editor-in-Chief) and David Phizackerley (DTB Deputy Editor) discuss the use of herbal products.

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