(DDM) – Medical researchers are calling for a re-evaluation of how the heart failure medication sacubitril/valsartan is prescribed, emphasizing that dosing must be individualized rather than standardized.
The findings were highlighted in a new mini-review published in the Journal of General Internal Medicine by Cen, Lin, and Ahmedy, who analyzed how real-world clinical evidence should shape dosing decisions for patients with heart failure with reduced ejection fraction (HFrEF).
The authors noted that sacubitril/valsartan, marketed globally under the brand name Entresto, has revolutionized the management of heart failure, offering patients improved survival and reduced hospitalization rates.
However, they warned that despite its benefits, many patients are not receiving optimal doses, which could significantly undermine the drug’s life-saving potential.
The study emphasized that the current “one-size-fits-all” dosing model may not suit the complex nature of heart failure patients, whose conditions vary based on renal function, medication interactions, and clinical tolerance.
Cen and his co-authors proposed that physicians must consider individual characteristics before adjusting doses, urging greater flexibility in treatment strategies.
They explained that although existing clinical guidelines recommend titration based on patient tolerance, real-world practice often reveals gaps between guideline recommendations and actual patient management.
The review pointed to real-world evidence (RWE) as a valuable tool in bridging this gap.
By studying patient data outside clinical trials, RWE helps clinicians understand how sacubitril/valsartan performs across diverse populations and health systems.
The authors also cautioned against underdosing, a widespread issue that may lead to poorer clinical outcomes and reduced drug efficacy.
According to the review, patients who remained on lower doses often experienced diminished quality of life and higher hospitalization risks than those reaching recommended therapeutic levels.
The research team urged healthcare systems to prioritize training programs that empower doctors and pharmacists to apply flexible dosing principles and engage in shared decision-making with patients.
They emphasized that effective communication between clinicians and patients is crucial to overcoming fears related to potential side effects such as hypotension or kidney dysfunction.
Cen and colleagues further highlighted the importance of continuous patient monitoring and follow-up, noting that telemedicine and integrated care models could help track progress and improve adherence.
They argued that regular check-ins allow clinicians to make timely dose adjustments, preventing complications and enhancing treatment success.
Another significant aspect discussed was the need to address racial and socio-economic disparities that affect access to heart failure treatments.
The researchers noted that certain populations remain underserved or undertreated due to affordability issues, lack of awareness, or systemic healthcare inequalities.
They called for standardized but adaptable dosing protocols that balance evidence-based guidelines with individualized care decisions.
In conclusion, the authors stated that optimizing sacubitril/valsartan dosing requires collaboration between clinicians, policymakers, and patients, stressing that personalized medicine is the key to achieving better heart failure outcomes.
Their findings underscore the evolving shift from rigid clinical frameworks to dynamic, patient-centered approaches that integrate real-world evidence, technology, and empathy into modern medical practice.
Medical experts around the world have welcomed the study, saying it reinforces the need to rethink conventional heart failure care and prioritize strategies that improve survival and quality of life.
