Effect of a combination of telmisartan and amlodipine in hypertensive dogs

Caro-Vadillo, Alicia; Daza-González, Maria Angeles; Gonzalez-Alonso-Alegre, Elisa M.; Rodríguez, Ángel Cervera; Gómez-García, José R.

doi:10.1136/vetreccr-2017-000471

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Clinical data regarding telmisartan's antihypertensive efficacy in dogs is limited to that of a single case series of 5 dogs with refractory systemic hypertension. 50 Prospective research in spontaneously hypertensive dogs is warranted to explore this drug's antihypertensive efficacy in this species.…”

Section: F I G U R Ementioning

confidence: 99%

Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double‐masked, randomized clinical trial

Lourenço

Coleman

Brown

et al. 2020

Veterinary Internal Medicne

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Background Information regarding efficacy of the angiotensin II receptor blocker, telmisartan, for treatment of proteinuria in dogs is limited. Objective To evaluate the antiproteinuric efficacy of telmisartan, as compared to enalapril, in dogs with chronic kidney disease and persistent, renal proteinuria. Animals Thirty‐nine client‐owned dogs with chronic kidney disease and urinary protein‐to‐creatinine ratio (UPC) > 0.5 (if azotemic) or ≥ 1.0 (if nonazotemic). Methods In this prospective, randomized, double‐masked clinical trial, dogs were block randomized, according to presence or absence of azotemia and systemic arterial hypertension, to receive telmisartan (1.0 mg/kg PO q24h), or enalapril (0.5 mg/kg PO q12h), and followed for 120 days. Up‐titration of study drug dosage on days 30 and 60, and addition of the other study drug at day 90, were performed if UPC > 0.5 was noted at these visits. Percentage change in UPC relative to baseline was calculated for all time points. Data are presented as median (range). Results Thirty‐nine (20 telmisartan‐treated, 19 enalapril‐treated) dogs were included. At day 30, percentage change in UPC was greater for telmisartan‐treated (−65% [−95% to 104%]) vs enalapril‐treated (−35% [−74% to 87%]) dogs ( P = .002). Among dogs persistently proteinuric at earlier visits, telmisartan remained superior to enalapril at days 60 ( P = .02) and 90 ( P = .02). No difference in percentage change in UPC between study groups was observed at day 120, when combination therapy was allowed. Combination therapy resulted in relevant azotemia in 4/13 (31%) dogs. Conclusions and Clinical Importance Telmisartan might be a suitable first‐line therapy for dogs with renal proteinuria.

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Section: F I G U R Ementioning

confidence: 99%

Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double‐masked, randomized clinical trial

Lourenço

Coleman

Brown

et al. 2020

Veterinary Internal Medicne

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“…During the study period, 60% of the dogs required treatment with an ACEI (ie, benazepril), and of these dogs, 41.9% needed an additional drug (ie, amlodipine), similar to what is described in people 6,54 . In veterinary medicine, telmisartan has proven to be effective in managing SH in cats 56 and, in combination with amlodipine, in dogs with SH refractory to treatment with ACEIs 57 . In HT dogs with HAC, telmisartan has been shown to control SH in 40% of dogs, whereas benazepril has been effective in 80% of the cases (González, S; Clares, I; Alonso, D; García del Real, R; García, P; Pérez, MD “Telmisartan versus benazepril on the management of systemic hypertension in dogs with hyperadrenocorticism” Research communications of the 28th ECVIM‐CA congress).…”

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

“…6,54 In veterinary medicine, telmisartan has proven to be effective in managing SH in cats 56 and, in combination with amlodipine, in dogs with SH refractory to treatment with ACEIs. 57 In HT dogs with HAC, telmisartan has been shown to control SH in 40% of dogs, whereas benazepril has been effective in 80% of the cases (González, S; Clares, I; Alonso, D; García del Real, R; García, P; Pérez, MD "Telmisartan versus benazepril on the management of systemic hypertension in dogs with hyperadrenocorticism" Research communications of the 28th ECVIM-CA congress). Our results could have been different if telmisartan had been used.…”

Section: Discussionmentioning

confidence: 99%

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Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

José

Arenas

Alonso-Miguel

et al. 2020

Veterinary Internal Medicne

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Background: Systemic hypertension (SH) is common in dogs and humans with hypercortisolism and can persist after treatment. Objectives: To evaluate changes in prevalence of SH and systolic blood pressure (SBP) in dogs with pituitary-dependent hyperadrenocorticism (PDH) during the first year of trilostane treatment, its relationship with disease control and selected laboratory variables, and their response to antihypertensive treatment. Animals: Fifty-one dogs with PDH treated with trilostane Q12h. Methods: Prospective case series study. Dogs were evaluated at diagnosis (T0) and 1, 3, 6, and 12 months (T12). Dogs were classified as nonhypertensive (SBP < 160 mm Hg) or hypertensive (SBP≥160 mm Hg) and subclassified according to target organ damage (TOD) risk. Hypertensive dogs were treated with benazepril and, if control of SH was not achieved, amlodipine was added. Results: Prevalence of SH decreased from T0 (36/51) to T12 (17/37; P = .01). Changes in SBP during the study were influenced by the risk of TOD at T0. In severely hypertensive (SBP ≥ 180 mm Hg) dogs, the decrease in SBP was more pronounced whereas in normotensive (SBP < 140 mm Hg) dogs SBP increased slightly (P = .00). Blood pressure was not associated with disease control. Antihypertensive treatment was needed in 31/51 dogs, and in 13/31 dogs additional SH control with amlodipine was required. One third of nonhypertensive dogs at T0 required treatment with benazepril because SH developed during follow-up. Conclusions and Clinical Importance: In dogs with PDH, SBP should be measured at every visit, regardless of disease control or SBP at diagnosis. More than 1 drug may be necessary to manage SH in affected dogs.

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“…Combining the angiotensin II receptor antagonist TEL with the calcium channel blocker AMD has the added benefit of reducing cardiovascular mortality and morbidity over other dual therapies while providing equivalent blood pressure control. Each antihypertensive drug has been combined with multiple other antihypertensive medications into a single pill, but this combination is unique, due to the complementary mechanisms of its components appear to enhance the effectiveness beyond that provided by each drug alone [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

International Conference on Harmonization Recommended Forced Degradation Studies and Development of a New Validated Isocratic Reverse-Phase Ultra High-Performance Liquid Chromatography Method for the Simultaneous Estimation of Telmisartan and Amlodipine I

Patra

Gowda

2019

Asian J Pharm Clin Res

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Objective: The objective of this research work is to develop a simple, rapid, cost-effective, accurate, precise, and robust stability-indicating reversephase ultra-high performance liquid chromatography method for the quantitative estimation of telmisartan (TEL) and amlodipine (AMD) in combined tablet dosage form. Methods: The method uses Poroshell 120EC-C18 column (4.6 mm × 50 mm, 2.7 μm) with an optimized mobile phase containing acetonitrile:50 mM ammonium acetate buffer in the ratio (45:55 v/v), pH adjusted to 4.5 with acetic acid. The flow rate was 0.5 ml/min, column temperature at 25°C and detection was monitored by a PDA detector at a wavelength of 245 nm. International Conference on Harmonization (ICH) recommended stress degradation studies were performed on TEL, AMD standard drugs, and tablet formulations; further stressed samples were analyzed by the proposed method. Results: Major degradation of TEL and AMD was observed under acidic, alkali, hydrolytic and oxidation conditions. The described method was validated as per the ICH guideline and validation parameters such as system suitability, linearity, accuracy, precision, specificity, and robustness results were within acceptable limits. Conclusion: The method was found to be suitable and accurate for quantitative estimation and stability study of title drugs in pharmaceutical preparations.

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Effect of a combination of telmisartan and amlodipine in hypertensive dogs

Cited by 7 publications

References 31 publications

Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double‐masked, randomized clinical trial

Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double‐masked, randomized clinical trial

Changes in systolic blood pressure in dogs with pituitary dependent hyperadrenocorticism during the first year of trilostane treatment

International Conference on Harmonization Recommended Forced Degradation Studies and Development of a New Validated Isocratic Reverse-Phase Ultra High-Performance Liquid Chromatography Method for the Simultaneous Estimation of Telmisartan and Amlodipine I

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