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  • Azmarda Outperforms...

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

Written By : Dr. Garima Soni Published On 2025-05-22T11:30:04+05:30  |  Updated On 22 May 2025 4:01 PM IST
Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study
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Ahmedabad: Azmarda, an innovator brand of Sacubitril/Valsartan, demonstrated superior efficacy compared to generic Sacubitril/Valsartan in patients with heart failure with reduced ejection fraction (HFrEF), as assessed using global longitudinal strain (GLS), a key evaluation parameter, a recent India study has shown.
The comparative study evaluating the efficacy and safety of Azmarda with generic Sacubitril/Valsartan; has been published in the
European Journal of Cardiovascular Medicine (EJCM).
Heart failure with reduced ejection fraction (HFrEF) impairs left ventricular function, which is traditionally assessed by left ventricular ejection fraction (LVEF). However, global longitudinal strain (GLS) measured through 2D-speckle tracking echocardiography provides greater sensitivity in detecting left ventricular (LV) systolic dysfunction.
While Sacubitril/Valsartan is an established therapy for HFrEF, Azmarda, the innovator version, is developed using patented co-crystal technology known for its unique pharmaceutical properties, which have been well established in in-vitro settings, unlike its generic counterpart formulations. Given the established advantage of this technology, a prospective, randomized, crossover study was conducted to compare the efficacy and safety of Azmarda versus generic Sacubitril/Valsartan using GLS and Time to Peak (TTP) as the primary assessment parameters.
The study involved 12 HFrEF patients with a mean age of 54.7 ± 6.5 years who were randomly assigned to receive either Azmarda or generic sacubitril/valsartan for 8 weeks, followed by a crossover to the alternate formulation for another 8 weeks. Both groups received the assigned medication twice daily over the 16-week treatment period. GLS and TTP were assessed from baseline to weeks 4, 8, 12, and 16, with safety monitored throughout the study.

The results revealed findings which include:

1. Changes in GLS measurements

  • At baseline, the mean GLS score was –12.8 ± 1.7% in the Azmarda group and –13.1 ± 1.4% in the generic sacubitril/valsartan group. Over the 16-week period, patients receiving Azmarda showed consistently greater improvement in GLS scores across all follow-up visits.
  • From baseline to week 4, the Azmarda group improved by –0.9 ± 0.1% compared to –0.2 ± 0.2% in the generic group. By week 8, the change was –1.7 ± 0.3% with Azmarda versus –0.5 ± 0.1% with the generic sacubitril/valsartan ( p<0.05).

From weeks 8 to 12, GLS improved by –0.7 ± 0.2% with Azmarda vs –0.2 ± 0.2% with the generic sacubitril/valsartan, and by week 16, the change was –1.4 ± 0.2% vs –0.4 ± 0.1% , for Azmarda and Generic group respectively. The difference observed in the change in GLS score between the Azmarda and the Generic group at weeks 12 and 16 (P =<0.05) was statistically significant.(Fig. 1)

Fig. 1. Mean GLS score and change in GLS score: The mean GLS score of patients in the Azmarda group (N=6) and Generic (sacubitril/valsartan) group (N=6) at baseline, and week 4,8,12 and 16.


2. Change in TTP measurements:

  • At baseline, the mean TTP was 373.7 ± 102.3 ms in the Azmarda group and 330.0 ± 44.1 ms in the Generic group (p = 0.42). By week 4 to 8, both groups showed reduced TTP, with a greater decline in the Azmarda group.
  • After crossover, Azmarda group showed a significant drop at week 12 (297.0 ± 13.7 ms) and week 16 (283.4 ± 16.7 ms), while the generic group showed an increase to 347.6 ± 20.9 ms and 352.2 ± 24.0 ms, respectively (p < 0.05). Byweek 16 the mean change in TTP score was –34.2 ± 36.7 ms for Azmarda versus +29.0 ± 25.3 ms for generic sacubitril/valsartan, showing significantly better myocardial contractile improvement with Azmarda.

3. Safety Assessments of both the groups: Over the 16-week study period, sacubitril/valsartan was well-tolerated, with no serious adverse events reported in either group.

This study demonstrated the superior efficacy of Azmarda, developed with unique co-crystal technology, over the generic sacubitril/valsartan formulation while displaying enhanced LV reverse remodeling in patients with HFrEF and further highlighted the value of GLS as a sensitive and reliable parameter for early detection of left ventricular systolic dysfunction.

“ Further studies with larger cohorts and long-term follow-up are required to confirm the long-term clinical benefits,” the authors further noted

Reference: Patel S. "Comparative Efficacy and Safety of Azmarda vs. Generic Sacubitril/Valsartan in Heart Failure with Reduced Ejection Fraction: A Prospective, Randomized, Active-Controlled Crossover Study." Eur J Cardiovasc Med. 2025;15(4): 928–934

azmardagenericHFrEF
Source : European Journal of Cardiovascular Medicine (EJCM)
Dr. Garima Soni
Dr. Garima Soni

    BDS, MDS(orthodontics)

    Dr. Garima Soni holds a BDS (Bachelor of Dental Surgery) from Government Dental College, Raipur, Chhattisgarh, and an MDS (Master of Dental Surgery) specializing in Orthodontics and Dentofacial Orthopedics from Maitri College of Dentistry and Research Centre. At medical dialogues she focuses on dental news and dental and medical fact checks against medical/dental mis/disinformation

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