Comparative efficacy and safety of Azmarda vs Other Generic Sacubitril and Valsartan in Heart Failure with Reduced Ejection Fraction.
This article is composed on supremacy of Azmarda over other generic medicine comprised of Sacubitril and Valsartan. After Covid19, worldwide peoples are suffering from many diseases related to lungs, heart, kidney, liver, pancreas. These are mainly affecting human physiology and organ ecosystem. Vaccination for Covid prevention and its sustainability are the major challenges for present and future generation. It is the most alarming situation, people with good fitness are abruptly attacked by unexpected immuno-deficient ailment, forced to be morbid. In this context, our concern is about the heart-failure with reduced ejection fraction and post recovery medication.
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| Azmarda Efficacy |
After the covid virus infection or the post vaccination, human body is being more fragile and prone to chronic diseases associated with the other genetic diseases like diabetes, hypertension, arthritis. This vaccination rapidly mutated our auto-immune system that results in the abnormality of blood count. It disturbs human body and it's equilibrium that contributes to abnormal variation in blood components e.g. erythrocytosis, platelet count variation and WBC count variation. It forces on cytogenetic mutation causing different types of cancer. This topic relates to the hyper platelet count in blood. As stated above, post facto phenomenon on covid vaccination, CBC is varied abnormality, most cases the platelet count is being abnormality higher without predefined symptoms, it makes blood cloggy. It deposits flakes in the blood vessels and randomly clots in the vessels. These depositions are mostly happening in the coronary arteries and veins, some of them deposited in the brains. While this deposition happens in the coronary vessels, it restricts the blood flow in the tissue of the heart so called myocardium. Consequently, the heart muscles will be weak gradually. It hampers the heart functionality, and it reduces the ejection fraction of heart. Heart failure with reduced ejection fraction (HFrEF) is a chronic condition. It greatly affects the myocardial function. Left ventricular ejection fraction (LVEF) is used to demonstrate and measure the heart function. It indicates the percentage of blood ejected from the Left Ventricle chamber per cycle. LVEF is dependent on ventricular loading and measured in 2D electrocardiography. So, it has short fall on early detection of cardio myopathy. But modern method, 2D speckles tracking echocardiography (STE) is the most updated technique to evaluate heart function and contractility. It uses global longitudinal strain (GLS). It is considered as the more sensitive and reliable method to measure LV systolic dysfunction than LVEF. However, the heart condition is categorised in three basic group. First one is the HF with preserved EF (HFpEF) having the LVEF with 50% and above. The second one is in the midrange HF (HFmrEF) having the EF in between 41% to 49%. The third one the lower EF having 40% and lower (HFrEF). The mid and lower group are treated with quadruple therapy like, ARNI, Beta-blocker, MRA and SGLT2i. Sacubitril and valsartan compiled medicine was approved by Food and Drug Administrator (FDA) in 2015 to treat the heart failure as the angiotensin receptor and neprilysin inhibitors (ARNI). It was originally developed (so called Entresto) by the Novartis Pharma, Italy. It was marketed in India by JB Chemicals under the Brand name, Azmarda. Till 2023, August before the completion of patent, it was only produced by the Novartis pharma. Later on, various generic Sacubitril/Valsartan are propagated in the market with competitive lower price. Peoples are attracted with these generic medicines, but a recent comparative study proves that Azmarda has the supremacy in it's effectiveness over these generic counterparts. Azmarda utilizes a patented polymorphic co-crystal technology which is associated with its unique pharmaceutical properties. This co-crystal formulation is tried and proven effective properties. Generic manufactures of Sacubitril/ Valsartan can't imitate the co-crystal technology. A recent article published in the "European Journal of Cardio-Vascular Medicine." on the efficacy of Azmarda. It demonstrated the co-crystal formulation of Azmarda exhibits superior physiochemical properties compared to various generic formulation. The study was conducted in 12 patients with HFrEF. Those patients were randomly assigned to either Azmarda or Generic sacubitril/ Valsartan for 8 weeks, followed by the crossover to the alternative formulation for another 8 weeks. GLS and TPP Scores were measured from base line to weeks 4,8,12 and 16. The results showed that patients treated with Azmarda demonstrated a larger improvement in GLS scores compared to other generic medicine administered group. It proves some uniqueness of Azmarda enhancing the LV function, reverse remodelling of HFrEF patients. Higher of value of GLS as a reliable factor for supremacy of Azmarda over other Generic composition. However further studies with larger cohorts and long term follow up are required to confirm the long-term clinical benefits.
Case Study of cardiac treatment of Md Kamal Uddin, 44 Years young man. Earlier it was already mentioned that this guy was victimised with the covid precaution doses. In the year 2022, he was vaccinated on 24th April. No such abnormality was faced but a sensed of immuno-deficiency syndrome. He was suddenly infected with chicken pox or varicella as he was contacted with his son having the infection of the same disease. Earlier he was in touch of various affected men but could not infected. Thus, it was taken 25 days to recover. During this period, occupational health check-up was conducted. He was also tested. As per the blood test report, it was astonishing that his blood cholesterol & triglyceride were at higher side though these were always within the normal allowable limit. It means & proves that there was happening an immuno-disturbance. However, it was searching for the bad instances that lead the physiological devastation within the multi-organ prevalences. On 15th of September 2022, it was an important day for him as being an engineer. It was celebrating in his office as the birthday of a renowned Indian engineer called M. Visveswaraya. Whole day was full of activities like seminar, project, discussion on engineering milestone and achievement. M K Uddin was in the full devotion in his work. That day he was full in his energy to execute his duties to troubleshoot a machine operation. He returned home & joined the party at 11 PM. With a meagre mill he completed his supper & returned back to home. Till then he was mostly energetic. While he woke up for toilet at 4.00 Hrs in the dawn. While he was going to urinal, he felt blank headiness & dizziness. He was then conscious of the situation & assumed that he had a cardiac trouble. He slowly reached to his bed & lie down. He called his wife to get a support from his colleagues. The helping guys, Mr. Pranob Guha came with his great majesty. Later he underwent through angioplasty on the day and later CABG (Coronary Artery Bypass Grafting) on 15.04.2023. After a critical passage he is surviving with medication under the cardiac surgeon, Mr. Manoj Kumar Daga, CVTS in B M Birla Heart Research Centre, Kolkata under jurisdiction of C K Birla Hospitals.
Till then he was treated with Azmarda 50 doses to improve his HFrEF of about 42%, Gradually the dose was increased Azmarda100. It was finely responding to increase the LVEF up to 50%. It was a hopeful recovery in the first one year of treatment. After 2023 August, the patent for manufacturing by the developer, Novartis Pharma was completed. Various generic medicine producer came to market & started to manufacture the Sacubitril/Valsartan composed generic product that is cheaper than Azmarda. He was treated with these generic products for another one year. At the end of year, he was tested and found no such improvement in LVEF as the first year treated with Azmarda. It is evidently explained that Azmarda has it's superiority over the other generic products in improving reduced heart function, improvement of GLS score and reverse cardiac remodelling. Again, he was strictly treated with Azmarda for next one year and waiting to find it's efficacy.
FAQ:
1) Why Azmarda is better heart failure medicine?
2) Which is the best ARNI Medicine?
3) Why Azmarda is unique over generic ARNI?
4) Composition and uses of Azmarda, sacubitril/ Valsartan medicine?
5) Which is manufacturer of Azmarda?
6) How to improve Low LVEF with Azmarda?
7) What is the Low, Mid and Preserved LVEF?
8) How does Azmarda work?
9) Is Azmarda a Blood Thinner, Beta-Blocker?
10) Can Azmarda increase LVEF?
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