Novartis announced the establishment of FortiHFy, the largest global clinical programme in the heart failure disease area across the pharma industry to date, comprising over 40 active or planned clinical studies designed to generate an array of additional data on symptom reduction, efficacy, quality of life benefits and real world evidence with its novel heart failure medicine Entresto (sacubitril/valsartan), and extend understanding of heart failure.

"The FortiHFy programme reinforces our long term commitment to improving heart failure treatment for as many people as possible," said Vas Narasimhan, global head, drug development and chief medical officer. "The outcomes of these trials will increase our understanding of heart failure, the patient population who may benefit from Entresto, and could potentially support applications to regulatory authorities".

Major trials in the FortiHFy programme include:

PARAGON-HF examining the efficacy and safety of Entresto in heart failure patients with with preserved ejection fraction (compared to valsartan), expected study completion in 2019;

PARADISE-MI testing the hypothesis that Entresto can reduce cardiovascular death, heart failure hospitalizations and new onset heart failure in patients at high risk for heart failure after a myocardial infarction, expected study completion in 2020;

TRANSITION comparing in-hospital initiation of Entresto to initiation after hospital discharge in heart failure patients with reduced ejection fraction (HFrEF) who have recently been hospitalized for acute decompensation, expected study completion in 2018;

PIONEER investigating the effect of in-hospital initiation of Entresto on changes in NT-proBNP (compared to enalapril) in patients with HFrEF following an acute decompensation, expected study completion in 2018

FortiHFy trials that are already active are posted on clinicaltrials.gov and are currently enrolling patients in more than 50 countries worldwide. Entresto is approved in 57 countries to date for the treatment of heart failure with reduced ejection fraction (HFrEF), based on data from the PARADIGM-HF study which reported results in 2014.

Heart failure is a debilitating and life-threatening condition, which impacts over 60 million people worldwide. It is the leading cause of hospitalization in people over the age of 65. About half of people with heart failure have HFrEF. Reduced ejection fraction means the heart does not contract with enough force, so less blood is pumped out. Heart failure presents a major and growing health-economic burden that currently costs the world economy $108 billion every year.

Entresto is a twice-a-day medicine that reduces the strain on the failing heart. It does this by enhancing the protective neurohormonal systems of the heart (NP system) while simultaneously suppressing the harmful effects of the overactive renin-angiotensin-aldosterone system (RAAS). Other heart failure medicines only block the harmful effects of the overactive RAAS. Entresto contains the neprilysin inhibitor sacubitril, which is a new molecular entity, and the angiotensin receptor blocker (ARB) valsartan.

In Europe, Entresto is indicated in adult patients for treatment of symptomatic chronic heart failure with reduced ejection fraction. In the US. Entresto is indicated for the treatment of heart failure (NYHA class II-IV) in patients with systolic dysfunction. It has been shown to reduce the rate of cardiovascular death and heart failure hospitalization compared to enalapril, and also to reduce the rate of all-cause mortality compared to enalapril. Entresto is usually administered in conjunction with other heart failure therapies, in place of an ACE inhibitor or other angiotensin receptor blocker (ARB). Approved indications may vary depending upon the individual country.