Sacubitril Valsartan CKD HARP-III — ESENeph MCQ

Correct answer: A — Avoid treating CKD with sacubitril–valsartan without a heart-failure indication

The best answer is “Avoid treating CKD with sacubitril–valsartan without a heart-failure indication”. Sacubitril-valsartan is a heart-failure therapy used when the NICE phenotype and treatment conditions are met; CKD alone does not create an indication. “Use sacubitril–valsartan for a qualifying heart-failure indication in CKD” is less appropriate because NICE recommends it for selected heart-failure phenotypes, not CKD alone “Use an SGLT2 inhibitor for an evidence-based CKD indication” is less appropriate because the drug classes have distinct indications and evidence “Adjust sacubitril–valsartan according to kidney function and potassium” is less appropriate because CKD does not create a universal contraindication when heart-failure criteria are met “Expect less bradykinin cough than with ACE-inhibitor treatment” is less appropriate because the clinical decision is not based on greater ACE-like cough

Reference: NICE NG106: chronic heart failure in adults: https://www.nice.org.uk/guidance/ng106/chapter/Recommendations