Table 4 |
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|
Results of clinical trials indicating the renoprotective nature of ARBs |
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|
Study |
Patients |
n |
Treatment |
Duration |
Principle findings |
|
|
|||||
|
AMADEO® [122] |
Hypertension and diabetic nephropathy |
860 |
Telmisartan or losartan |
52 weeks |
Telmisartan was superior to losartan in reducing proteinuria |
|
|
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|
CALM [25] |
Type 2 diabetes with hypertension and microalbuminuria |
199 |
Candesartan, lisinopril or both |
24 weeks |
Candesartan was as effective as lisinopril in reducing UACR. Combined treatment was associated with a greater reduction in UACR than monotherapeutic treatment (statistically significant versus candesartan monotherapy) |
|
|
|||||
|
DETAIL® [99] |
Hypertension, Type 2 diabetes and early nephropathy |
250 |
Telmisartan or enalapril |
5 years |
Telmisartan was not inferior to enalapril in providing long-term renoprotection |
|
|
|||||
|
IDNT [119] |
Hypertension and diabetic nephropathy |
1715 |
Irbesartan, amlodipine or placebo |
Mean 2.6 years |
Irbesartan was superior to amlodipine and placebo in preventing the primary composite end point of: a doubling of the base-line serum creatinine concentration, the development of ESRD, or death from any cause. This was independent of BP |
|
|
|||||
|
IRMA 2 [118] |
Hypertension, type 2 diabetes and microalbuminuria |
590 |
Irbesartan or Placebo |
2 years |
Irbesartan was superior to placebo in preventing diabetic nephropathy |
|
|
|||||
|
MARVAL [121] |
Diabetic nephropathy with and without hypertension |
332 |
Valsartan or amlodipine |
24 weeks |
Valsartan was superior to amlodipine in reducing microalbuminuria |
|
|
|||||
|
RENAAL [120] |
Diabetic nephropathy |
1513 |
Losartan or placebo |
Mean 3.4 years |
Losartan was superior to placebo in preventing increases in UACR and progression to ESRD. There was no difference in mortality |
|
|
|||||
|
ROADMAP [123] |
Type 2 diabetes with normoalbuminuria |
4449 |
Olmesartan or placebo |
Median 3.2 years |
Olmesartan delayed the time to onset of microalbuminuria (statistical significance lost on adjustment for blood pressure difference) |
|
|
|||||
|
VIVALDI® [124] |
Hypertension and diabetic nephropathy |
885 |
Telmisartan or valsartan* |
52 weeks |
Telmisartan and valsartan provided similar renoprotection |
|
|
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|
Abbreviations: AMADEO® = A trial to compare telMisartan 40 mg titrated to 80 mg versus losArtan 50 mg titrated to 100 mg in hypertensive type 2 DiabEtic patients with Overt nephropathy; ARB = angiotensin II receptor blocker; BP = blood pressure; CALM = CAndesartan and Lisinopril Microalbuminuria; DETAIL® = Diabetics Exposed to Telmisartan And enalaprIL study; ESRD, end-stage renal disease; IDNT = Irbesartan type II Diabetic Nephropathy Trial; IRMA2 = IRbesartan in patients with type 2 diabetes and MicroAlbuminuria; MARVAL = MicroAlbuminuria Reduction with VALsartan trial; RENAAL = Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan; ROADMAP = Randomized Olmesartan And Diabetes Microalbuminuria Prevention; UACR = urine albumin:creatinine ratio; VIVALDI® = A trial to inVestigate the efficacy of telmIsartan versus VALsartan in hypertensive type 2 DIabetic patients with overt nephropathy. *Additional hypertensive treatment was allowed in VIVALDI®. |
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|
Mallat Cardiovascular Diabetology 2012 11:32 doi:10.1186/1475-2840-11-32 |
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