Comparative efficacy and safety of fimasartan in patients with hypertension: A network meta‐analysis of randomized controlled trials

Abstract

Hypertension is a prevalent risk factor for cardiovascular disease. Angiotensin II receptor blockers are widely prescribed to patients with hypertension, while new drugs are continuously developed. However, data on comparative efficacy and safety of novel agents, such as fimasartan, are scarce. Here, we aimed to collect clinical evidence on different angiotensin II receptor blockers using a network meta‐analysis. Randomized controlled trials whose follow‐up time is within 12 weeks were identified from eight databases via a systematic literature review. Of the 7909 possibly relevant studies, 61 studies with 14,249 adult patients were included in the analysis. These studies were further subjected to quality appraisal using Cochran's Risk of Bias, and sitting systolic blood pressure was considered the primary endpoint. A Bayesian random effect generalized linear model was used for the network meta‐analysis, and the treatment rank probability was determined. Olmesartan (standardized mean difference ‐0.987 [‐1.29, ‐0.729]) and fimasartan (standardized mean difference ‐0.966 [‐1.21, ‐0.745]) showed the highest rank probabilities (37% and 35%) in the 4‐week group, considering the primary endpoint. Furthermore, the odds ratio of adverse events for all agents did not differ significantly from that of the placebo. The treatment rank of angiotensin II receptor blockers varied depending on the outcome type and follow‐up period considerably. Fimasartan rapidly lowered blood pressure in 4 weeks, which was further maintained until 12 weeks, indicating its competent efficacy and tolerability. Our findings may help medical practitioners and patients to select the best angiotensin II receptor blocker against hypertension.

Design of a multi-target focused library for antidiabetic targets using a comprehensive set of chemical transformation rules

“…In particular, PPARs have demonstrated clinical efficacy in metabolic diseases such as T2DM and those related to lipid metabolism, which has led to testing and optimization of different compounds such as fibrates and TZDs to simultaneously modulate multiple targets, with a synergistic effect on T2DM and MetS (Ammazzalorso et al, 2019). Other compounds under investigation or in any of the experimental phases by the FDA include elafibranor for PPARα/δ (Schattenberg et al, 2021), telmisartan and fimasartan for PPARγ/AT1 (Seo et al, 2022), lanifibranor and sodelglitazar for PPARα/δ/γ (Kamata et al, 2023) and licogliflozin and sotagliflozin for SGLT1-2, the latter already approved by the FDA in 2023 to reduce the risk of cardiovascular death and heart failure in adults with heart failure, T2DM, chronic kidney disease, and other cardiovascular risk factors (Packer, 2023). An attractive approach to exploring and expanding the chemical space around the first hit compounds of single and multi-target compounds is the computational generation of chemical libraries that can be used in virtual screening campaigns (Walters, 2019).…”