What are the benefits of Verquvo (sacubitril/valsartan)?

From the Guidelines

Verquvo (vericiguat) is a medication that benefits patients with chronic heart failure by reducing the risk of cardiovascular death and heart failure hospitalizations, as supported by recent guidelines 1. It works by stimulating soluble guanylate cyclase, which improves heart function and blood flow. The typical starting dose is 2.5 mg once daily, which can be increased to 5 mg and then 10 mg daily at two-week intervals as tolerated. Patients should be aware that Verquvo is contraindicated during pregnancy as it may harm the fetus, and women of childbearing potential should use effective contraception. Common side effects include low blood pressure and anemia. The medication should be taken with food at approximately the same time each day. If a dose is missed, patients should take it as soon as they remember on the same day but should not double the dose the next day. Verquvo is specifically beneficial for patients with symptomatic chronic heart failure with reduced ejection fraction who have had a recent worsening heart failure event requiring hospitalization or IV diuretics.

Some key points to consider when prescribing Verquvo include:

• It is recommended for patients with symptomatic heart failure with reduced ejection fraction who remain symptomatic despite optimal treatment with an ACE-I, a beta-blocker, and an MRA, as stated in the 2016 ESC guidelines 1.
• The 2024 ESC guidelines for the management of chronic coronary syndromes also support the use of Verquvo in patients with heart failure 1.
• The 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure provides recommendations for the use of ARNI therapy in patients with symptomatic HFrEF, which may be relevant to the use of Verquvo 1.
• Patients with a history of angioedema should not be administered Verquvo, as it may increase the risk of a recurrence of angioedema, as noted in the 2017 ACC/AHA/HFSA guidelines 1.

Overall, Verquvo is a valuable treatment option for patients with chronic heart failure, and its benefits and potential side effects should be carefully considered when prescribing this medication.

From the FDA Drug Label

VERQUVO was superior to placebo in reducing the risk of CV death or heart failure hospitalization based on a time-to-event analysis (hazard ratio [HR]: 0.90,95% confidence interval [CI], 0.82-0.98; p=0.019). The treatment effect reflected a reduction in both cardiovascular death and heart failure hospitalization. VERQUVO was superior to placebo in reducing the risk of total (first and recurrent) events of HF hospitalization and the first occurrence of either all-cause mortality or HF hospitalization.

The benefits of Verquvo include:

• Reduced risk of cardiovascular death
• Reduced risk of heart failure hospitalization
• Reduced risk of total events of heart failure hospitalization
• Reduced risk of all-cause mortality or heart failure hospitalization 2

From the Research

Benefits of Verquvo

• Verquvo (vericiguat) is an effective treatment option for patients with symptomatic, chronic heart failure with reduced ejection fraction (HFrEF) who have experienced a recent worsening event 3, 4, 5.
• The addition of vericiguat to standard of care has been associated with a significantly lower risk of death from cardiovascular causes or first hospitalization for heart failure compared to placebo 3, 4, 5.
• Vericiguat has also been shown to reduce the risk of all-cause mortality or first hospitalization for heart failure, as well as the total number of hospitalizations for heart failure 3, 4, 5.
• The drug is generally well-tolerated, with the most common treatment-related adverse event being hypotension 3, 4, 5.
• Vericiguat may be particularly beneficial for patients who do not tolerate available heart failure therapies, and its oral formulation makes it a convenient treatment option 5.
• A systematic review of randomized controlled trials suggests that vericiguat is effective in preventing all causes of death, cardiovascular death, and hospitalizations due to heart failure, regardless of atrial fibrillation status or NT-proBNP levels up to 8000 pg/ml 6.

Efficacy and Safety

• The phase III VICTORIA trial demonstrated the efficacy and safety of vericiguat in patients with chronic HFrEF 3, 4, 5.
• Vericiguat has been shown to be safe and effective for reducing the risk of cardiovascular death and heart failure hospitalization in adults with symptomatic chronic heart failure and reduced ejection fraction 5.
• However, the safety of vericiguat, particularly at higher dosages, has been raised as a concern 6.
• The most common side effects of vericiguat include hypotension, syncope, and anemia 4, 5.