Aliskiren as Add-On Therapy in the Treatment of Hypertensive Diabetic Patients Inadequately Controlled with Valsartan/HCT Combination

Drummond, Waymon; Sirenko, Yurii Konstantinovich; Ramos, Eladio; Baek, In-Young; Keefe, Deborah L.

doi:10.2165/11591970-000000000-00000

Cited by 12 publications

(8 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Six trials [ 14 - 19 ] involved in the analysis of antihypertension and the result suggested aliskiren in combination therapy with ACEs/ARBs was superior to ACEI or ARB monotherapy in SBP reduction (WMD, -4.20; 95% CI -5.44 to -2.97; I 2 , 29.7%) and DBP reduction (WMD, -2.09; 95% CI -2.90 to -1.27; I 2 , 0%) as described in Figure 3B .…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies [ 9 , 14 , 15 , 17 , 19 - 24 ] reported on the outcome of hyperkalaemia (Table 2 and Figure 3A ). Combination therapy was significantly associated with the risk of hyperkalaemia compared with an ACEI or an ARB monotherapy (RR 1.45; 95% CI 1.28 to 1.64; I 2 , 10.6 %).…”

Section: Resultsmentioning

confidence: 99%

“…Eight studies [ 14 , 15 , 17 , 19 , 20 , 22 - 24 ] involved in kidney injury (Table 2 and Figure 3A ). Combination therapy was markedly associated with the risk of kidney injury compared with an ACEI or an ARB monotherapy (RR, 1.92; 95% CI 1.14 to 3.21; I 2 , 0%).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Wen

Han

et al. 2017

Oncotarget

View full text Add to dashboard Cite

The efficacy and safety of aliskiren combination therapy with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in patients with hypertension and cardiovascular disease remains attractive attention. We searched the Cochrane Central Register, the Clinical Trials Registry, EMBASE, MEDLINE and PubMed for relevant literatures up to January 2017. A total of 13 randomized controlled trials (RCTs) with 12222 patients were included in this study, and the combined results indicated that aliskiren in combination therapy with ACEIs or ARBs had remarkable effects in reducing systolic blood pressure (SBP) [weighted mean differences (WMD), -4.20; 95% confidential intervals (CI) -5.44 to -2.97; I2, 29.7%] and diastolic blood pressure (DBP: WMD, -2.09; 95% CI -2.90 to -1.27; I2, 0%) when compared with ACEIs or ARBs monotherapy, but with significantly increased the risk of hyperkalaemia [relative risk (RR), 1.45; 95% CI 1.28 to 1.64; I2,10.6 %] and kidney injury ( RR, 1.92; 95% CI 1.14 to 3.21; I2, 0%). Besides, there was no significant difference in the incidence of major cardiovascular events (RR, 0.95; 95% CI 0.89 to 1.02; I2, 0%) between the combined therapy and ACEIs or ARBs monotherapy. In conclusion, this meta-analysis demonstrated that aliskiren in combination therapy with ACEs/ARBs could control BP effectively, but is associated with increasing risks of hyperkalaemia and kidney injury, and have no benefit in preventing of major cardiovascular events.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Wen

Han

et al. 2017

Oncotarget

View full text Add to dashboard Cite

show abstract

“…ALI monotherapy was superior to RAM monotherapy for msSBP reduction and non-inferior for msDBP reduction [32]. The addition of ALI 300 mg in the VAL/HCTZ 160/25 mg regimen in diabetic individuals showed greater BP reductions, however this did not achieve statistical significance [60]. In a recent randomized control trial by Imbalzano et al, ALI addition to optimal antihypertensive therapy showed higher BP and microalbuminuria reductions than LOS or RAM addition in patients with uncontrolled BP and DM [79].…”

Section: Aliskiren and Blood Pressure Loweringmentioning

confidence: 99%

Renin Inhibition with Aliskiren: A Decade of Clinical Experience

Pantzaris

Karanikolas

Tsiotsios

et al. 2017

JCM

View full text Add to dashboard Cite

The renin-angiotensin-aldosterone system (RAAS) plays a key role in the pathophysiology of arterial hypertension as well as in more complex mechanisms of cardiovascular and renal diseases. RAAS-blocking agents like angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers, have long been key components in the treatment of essential hypertension, heart failure, diabetic nephropathy, and chronic kidney disease, showing benefits well beyond blood pressure reduction. Renin blockade as the first step of the RAAS cascade finally became possible in 2007 with the approval of aliskiren, the first orally active direct renin inhibitor available for clinical use and the newest antihypertensive agent on the market. In the last decade, many clinical trials and meta-analyses have been conducted concerning the efficacy and safety of aliskiren in comparison to other antihypertensive agents, as well as the efficacy and potential clinical use of various combinations. Large trials with cardiovascular and renal endpoints attempted to show potential benefits of aliskiren beyond blood pressure lowering, as well as morbidity and mortality outcomes in specific populations such as diabetics, heart failure patients, and post-myocardial infarction individuals. The purpose of this review is to present the currently available data regarding established and future potential clinical uses of aliskiren.

show abstract

“…оценивали антигипертензивный эффект добавления Алискирена по сравнению с плацебо у 328 пациентов СД2 с неадек-ватным контролем АД на терапии Валсартаном 160 мг/сут и гидрохлоротиазидом (ГХТ) 25 мг/сут. Через 12 недель лечения снижение САД и ДАД было более выражено в группе больных, получавших Алискирен 300 мг в соче-тании с Валсартаном 160 мг и ГХТ 25 мг, по сравнению с группой плацебо, хотя различия не достигали уровня статистической значимости [12].…”

Section: результатыunclassified

The efficacy and safety of dual blockage of the renin-angiotensin-aldosterone system in patients with type 2 diabetes, hypertension and obesity without renal dysfunction

A¹,

Викулова²,

E³

et al. 2012

Obes. metabol.

View full text Add to dashboard Cite

The purpose of the study was to evaluate the clinical efficacy and safety of dual RAAS blockage during treatment with angiotensin-converting enzyme (ACE) inhibitors in combination with a direct renin inhibitor (PIR) aliskiren versus combination therapy with ACE inhibitors and angiotensin receptor blocker II (ARB) valsartan in patients with type 2 diabetes mellitus (T2DM), arterial hypertension (AH) and obesity, without renal dysfunction. Materials and methods. The study included 26 patients with T2DM (10 men and 16 women, mean age 59,0±6,2 years) with inadequate control of blood pressure (over 130 and/or 80 mm Hg) on prior antihypertensive therapy and without renal dysfunctions (glomerular filtration rate (GFR) 60 ml/min/1, 73 m2 and the of albumin/creatinine (A/C) ratio in the morning urine sample 10 mg/mol). After screening with the continuation of the initial therapy, including ACE inhibitors, 14 patients were added aliskiren 150–300 mg/day, 12 patients – valsartan 80–160 mg/day. Evaluation of the treatment effectiveness in terms of blood pressure (mean of three consecutive measurements in the sitting position) and the parameters of renal function (serum creatinine and potassium, GFR, A/C ratio in the urine) was performed at 4, 12 and 24 weeks of therapy. Results. In the group of patients treated with aliskiren, after 4 weeks of treatment a significant decrease in systolic and diastolic blood pressure (SBP and DBP, respectively) was noted as compared to baseline: 146,1 and 138,9 mm Hg, p0,05, 87,1 and 81,1 mm Hg, p 0,05, respectively; with systolic BP after 24 weeks of treatment decreased to 127,8 (-18,2 mm Hg), p0,05, diastolic BP to 75,0 (-12, 1 mm Hg), p0,05, the target blood pressure (≤130/80 mm Hg) was achieved in 83% of patients. The group of patients treated with valsartan, after 4 weeks of therapy showed a significant reduction in systolic BP 148 and 141,6 mm Hg, p 0,05, diastolic BP - to 85,8 and 81,7 mm Hg, p=0,059; after 24 weeks systolic BP decreased to 128,7 (-19,3 mm Hg), p=0,05, diastolic BP – to 77,5 (-8,3 mm Hg), p=0,07, the target blood pressure was achieved in 78% of patients. When monitoring the safety of therapy in terms of potassium, serum creatinine, GFR, and A/C urine ratio statistically significant differences between the groups at 4, 12, 24 weeks of treatment were observed. Conclusion. Results of the study demonstrate the efficacy and safety of dual RAAS blockage in patients with T2DM and obesity with no prior renal impairment.

show abstract

Aliskiren as Add-On Therapy in the Treatment of Hypertensive Diabetic Patients Inadequately Controlled with Valsartan/HCT Combination

Abstract: The reductions in BP with aliskiren added to valsartan/HCT in this study were numerically greater compared with placebo added to valsartan/HCT, although not statistically significant.

Cited by 12 publications

References 31 publications

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Aliskiren therapy in hypertension and cardiovascular disease: a systematic review and a meta-analysis

Renin Inhibition with Aliskiren: A Decade of Clinical Experience

The efficacy and safety of dual blockage of the renin-angiotensin-aldosterone system in patients with type 2 diabetes, hypertension and obesity without renal dysfunction

Contact Info

Product

Resources

About