Which combination drug is used in angiotensin receptor-neprilysin inhibitors (ARNIs)?

Which combination drug is used in angiotensin receptor-neprilysin inhibitors (ARNIs)?

• A. Enalapril, lisinopril
• B. Sacubitril/valsartan (Entresto)
• C. Valsartan/losartan
• D. Sacubitril/losartan

Answer: (B)

The key idea is that an ARNI combines a neprilysin inhibitor with an angiotensin receptor blocker to both boost protective natriuretic peptide effects and suppress the harmful RAAS. The drug that does this exact pairing is sacubitril/valsartan (Entresto), where sacubitril inhibits neprilysin and valsartan blocks the angiotensin II type 1 receptor. This combination reduces preload and afterload, improves hemodynamics, and has shown mortality and hospitalization benefits in heart failure with reduced ejection fraction. Enalapril and lisinopril are ACE inhibitors, which lower angiotensin II formation but do not provide neprilysin inhibition. Valsartan/losartan is two ARBs with no neprilysin inhibition. Sacubitril/losartan pairs neprilysin inhibition with an ARB, but the approved ARNI is sacubitril/valsartan, making it the correct choice.

The key idea is that an ARNI combines a neprilysin inhibitor with an angiotensin receptor blocker to both boost protective natriuretic peptide effects and suppress the harmful RAAS. The drug that does this exact pairing is sacubitril/valsartan (Entresto), where sacubitril inhibits neprilysin and valsartan blocks the angiotensin II type 1 receptor. This combination reduces preload and afterload, improves hemodynamics, and has shown mortality and hospitalization benefits in heart failure with reduced ejection fraction.

Enalapril and lisinopril are ACE inhibitors, which lower angiotensin II formation but do not provide neprilysin inhibition. Valsartan/losartan is two ARBs with no neprilysin inhibition. Sacubitril/losartan pairs neprilysin inhibition with an ARB, but the approved ARNI is sacubitril/valsartan, making it the correct choice.