Aliskiren (Rasilez®) is the first in a new drug class of oral direct renin inhibitors. Renin inhibition inhibits the conversion of angiotensinogen to angiotensin I. This is the rate-limiting step in the production of angiotensin II, which is a key mediator of blood pressure, body fluid volume, and vascular remodeling. It is administered at either 150 mg or 300 mg orally once daily.
Entresto (a tablet comprising a combination of the drugs sacubitril and valsartan), is in clinical development for people with chronic heart failure with preserved ejection fraction. Heart Failure (HF) is a complex clinical syndrome of symptoms and signs that suggest the efficiency of the heart as a pump is impaired. Symptoms include breathlessness and fatigue, and signs of the condition include swollen ankles and crackling sounds in the lungs. People with HF often have a poor quality of life, and about a third of people experience severe and prolonged depressive illness. About half of people with HF have a preserved ejection fraction (HF-PEF), meaning that over 50% of the blood in the left ventricle is pumped out with each contraction of the heart.