Which therapy combines neprilysin inhibition with angiotensin receptor blockade and may offer superior efficacy?

Which therapy combines neprilysin inhibition with angiotensin receptor blockade and may offer superior efficacy?

• A. ACE inhibitors
• B. ARBs
• C. Beta blockers
• D. ARNi

Answer: (D)

This question targets understanding a drug class that both boosts protective peptide signaling and blocks harmful RAAS activity. Neprilysin degrades natriuretic peptides, leading to vasoconstriction, sodium retention, and remodeling when unchecked. Inhibiting neprilysin increases natriuretic peptides, promoting vasodilation, natriuresis, and anti-remodeling effects. When this is paired with blocking the angiotensin II receptor, you get a dual approach: enhanced vasodilation and reduced angiotensin II–driven damage. This combination defines an angiotensin receptor–neprilysin inhibitor, a therapy that has demonstrated superior outcomes compared with traditional ACE inhibitors in heart failure with reduced ejection fraction, particularly lower mortality and fewer hospitalizations. It’s used with an ARB, not an ACE inhibitor, to avoid increased risk of angioedema.

This question targets understanding a drug class that both boosts protective peptide signaling and blocks harmful RAAS activity. Neprilysin degrades natriuretic peptides, leading to vasoconstriction, sodium retention, and remodeling when unchecked. Inhibiting neprilysin increases natriuretic peptides, promoting vasodilation, natriuresis, and anti-remodeling effects. When this is paired with blocking the angiotensin II receptor, you get a dual approach: enhanced vasodilation and reduced angiotensin II–driven damage. This combination defines an angiotensin receptor–neprilysin inhibitor, a therapy that has demonstrated superior outcomes compared with traditional ACE inhibitors in heart failure with reduced ejection fraction, particularly lower mortality and fewer hospitalizations. It’s used with an ARB, not an ACE inhibitor, to avoid increased risk of angioedema.