Effectiveness and Effect on Renal Parameters of Amlodipine vs. Other Dihydropyridine Calcium Channel Blockers in Patients with Essential Hypertension: Retrospective Observational Study Based on Real-World Evidence from Electronic Medical Records

Jadhav, Uday; Mohanan, Padhinhare P.; Abraham, Georgi; Khan, Mohammed Yunus; Gaurav, Kumar; Mane, Amey; Vikas, Seema; Jain, Mukesh Kumar; Meel, Bhavesh

doi:10.1007/s40119-021-00224-8

Cited by 6 publications

(6 citation statements)

References 23 publications

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“…Our pooled analysis also shows that cilnidipine does not significantly change serum creatinine levels as well as GFR. But this study provides evidence that cilnidipine has renal protective actions as it significantly decreases proteinuria in CKD patients, which supports the previous meta-analysis in which renal function was assessed among hypertensive patients receiving cilnidipine and L-type CCBs and cilnidipine showed better improvement in urinary protein excretion with similar effect on serum creatinine [16]. It can be explained by N-channel blocking the action of cilnidipine.…”

Section: Discussionsupporting

confidence: 88%

Blood Pressure Reducing Potential and Renoprotective Action of Cilnidipine Among Hypertensive Patients Suffering From Chronic Kidney Disease: A Meta-Analysis

Rohilla¹,

Sinha²,

Toppo³

et al. 2023

Cureus

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Hypertension is a risk factor for cardiovascular diseases which also causes progressive kidney damage leading to chronic kidney disease (CKD), so the rate of progression of CKD can be controlled by reducing blood pressure (BP). Many anti-hypertensive drugs are available. Cilnidipine is a new-generation calcium channel blocker (CCB). This meta-analysis is aimed to generate pooled evidence about the effectiveness of cilnidipine as an anti-hypertensive and to explore its reno-protective actions. Pubmed, Scopus, Cochrane Library, and Google Scholar were searched from January 2000 to December 2022 to include the studies. The pooled mean difference, along with 95% CI, was computed using Revman 5.4.1 software (Revman International, Inc., New York City, New York). The Cochrane risk-of-bias assessment tool was used for bias assessment. This meta-analysis was registered in PROSPERO with Reg. no. CRD42023395224. This metaanalysis included seven studies with 289 participants in the intervention group and 269 in the comparator group, and were selected from Japan, India, and Korea. Systolic blood pressure (SBP) was significantly reduced in cilnidipine treated group among hypertensives with CKD subjects weighted mean difference (WMD) was 4.33, and the 95% confidence interval (CI) was 1.26 to 7.31 as compared to the other group. Cilnidipine also shows a significant reduction in proteinuria with WMD 0.61 and 95% CI 0.42 to 0.80. Both groups were similar in adverse drug reactions (ADR). Cilnidipine is a more effective anti-hypertensive as compared to Amlodipine or other CCBs, mainly in reducing SBP. Besides this, cilnidipine also shows better reno-protective action because it also significantly reduces proteinuria in such patients.

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Section: Discussionsupporting

confidence: 88%

Blood Pressure Reducing Potential and Renoprotective Action of Cilnidipine Among Hypertensive Patients Suffering From Chronic Kidney Disease: A Meta-Analysis

Rohilla¹,

Sinha²,

Toppo³

et al. 2023

Cureus

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“…Azelnidipine has no obvious toxic side effects in the clinical treatment of hypertension. 48 Therefore, azelnidipine is a valuable FDA-approved drug targeting MEK1/2 in the chemoprevention of ESCC.…”

Section: Discussionmentioning

confidence: 99%

Azelnidipine inhibits esophageal squamous cell carcinoma proliferation in vivo and in vitro by targeting MEK1/2

Zhao

Zhang

et al. 2022

Molecular Therapy - Oncolytics

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“…The corresponding percentage of patients in cilnidipine group was 14.5%. Jadhav et al (2021), in an EMR-based study, comparing amlodipine with other CCBs, on Indian population observed amlodipine as the preferred drug of choice with long-lasting effectiveness and greater effect at lower doses [ 27 ]. Amlodipine with longer half-life ( t 1/2 = 30–60 hours) than cilnidipine half-life ( t 1/2 = 2.5 hours), high bioavailability, and affordability has an added advantage as antihypertensive for Indian population.…”

Section: Discussionmentioning

confidence: 99%

A Retrospective, Observational, EMR-Based Real-World Evidence Study to Assess the Incidence of Pedal Edema in Essential Hypertensive Patients on Amlodipine or Cilnidipine

Dalal

Sawhney

Jayagopal³

et al. 2022

International Journal of Hypertension

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Introduction. Calcium channel blockers have pedal edema as one of the confining factors of treatment. A real-world study may help evident reality of the situation in regular Indian clinical practice. The aim of the study is to assess effectiveness and incidence of pedal edema in essential hypertensive patients treated with amlodipine or cilnidipine monotherapy. Methods. Retrospective EMR data of adult essential hypertensive patients, prescribed amlodipine (n = 800) or cilnidipine (n = 800) as monotherapy, were analyzed. Incidence of pedal edema from baseline visit was analyzed in terms of dose and duration of treatment. The changes in systolic (SBP) and diastolic blood pressure (DBP) from baseline and proportion of patients achieving target BP goals were assessed. Results. In amlodipine and cilnidipine groups, mean changes in SBP and DBP from baseline to end of the study period were 28.4 and 15.1 mmHg and 24.3 and 13.5 mmHg, respectively ( p value <0.05). More than 50% of patients in both groups achieved BP goal at the end of the study ( p value 0.266). In amlodipine group, total 23.9% reported pedal edema, while in cilnidipine, 27.6% ( p value 0.0863). At the end of the study, 3.5% and 8.2% of patients remain with pedal edema, respectively, in both groups ( p value <0.005). Conclusion. Amlodipine demonstrated greater BP reduction at a lower average dose, better efficacy, and tolerability in terms of pedal edema count as a lesser number of patients reported edema at the end of the study and a higher percentage of patients continued the prescribed baseline dosage regimen as compared to cilnidipine. Thus, the study established amlodipine as an effective and well-tolerated antihypertensive for Indians.

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Effectiveness and Effect on Renal Parameters of Amlodipine vs. Other Dihydropyridine Calcium Channel Blockers in Patients with Essential Hypertension: Retrospective Observational Study Based on Real-World Evidence from Electronic Medical Records

Cited by 6 publications

References 23 publications

Blood Pressure Reducing Potential and Renoprotective Action of Cilnidipine Among Hypertensive Patients Suffering From Chronic Kidney Disease: A Meta-Analysis

Blood Pressure Reducing Potential and Renoprotective Action of Cilnidipine Among Hypertensive Patients Suffering From Chronic Kidney Disease: A Meta-Analysis

Azelnidipine inhibits esophageal squamous cell carcinoma proliferation in vivo and in vitro by targeting MEK1/2

A Retrospective, Observational, EMR-Based Real-World Evidence Study to Assess the Incidence of Pedal Edema in Essential Hypertensive Patients on Amlodipine or Cilnidipine

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