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Placebo‐controlled comparison of candoxatril, an orally active neutral endopeptidase inhibitor, and captopril in patients with chronic heart failure
Author(s) -
Northridge David B.,
Currie Peter F.,
Newby David E.,
McMurray John J.V.,
Ford Michael,
Boon Nicholas A.,
Dargie Henry J.
Publication year - 1999
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/s1388-9842(98)00003-8
Subject(s) - medicine , captopril , orally active , heart failure , neprilysin , placebo , pharmacology , ace inhibitor , enzyme inhibitor , cardiology , angiotensin converting enzyme , oral administration , enzyme , biochemistry , blood pressure , chemistry , alternative medicine , pathology
Aims: To compare the effects on exercise capacity of the neutral endopeptidase inhibitor candoxatril, and the angiotensin converting enzyme inhibitor captopril, in patients with mild to moderate heart failure. Methods: In this multi‐centre double‐blind placebo controlled study, 60 patients with NYHA Class I–III heart failure were randomised to candoxatril 200 mg b.d. ( n = 22), captopril 25–50 mg b.d. ( n = 23) or placebo ( n = 15), Treadmill exercise tests were carried out weekly during a 5‐week single‐blind placebo run‐in phase until a stable baseline was achieved, and repeated at 4 weekly intervals during the 12‐week double‐blind treatment phase. Results: Nine patients withdrew from the study — four candoxatril and five captopril. The placebo‐adjusted increase in exercise duration after 12 weeks was 56 s (95% CI, −26 to + 137 s; P = 0.12) with candoxatril and 37 s (− 40 to + 117 s; P = 0.29) with captopril. Conclusions: Both candoxatril and captopril were well tolerated and treadmill exercise duration appeared to increase during 12 weeks of therapy but this did not achieve statistical significance. This study tentatively suggests that in patients with heart failure, neutral endopeptidase inhibition may provide similar symptomatic benefits to angiotensin converting enzyme inhibition.