Key result
Fimasartan reduces clinic sitting SBP by ~2.6 mm Hg versus comparators.
Why the study?
Fimasartan has been investigated extensively, but a systematic review and meta-analysis evaluating its blood pressure-lowering effect against comparators using a cross-inference system was needed.
Does fimasartan reduce blood pressure more effectively than comparators in patients requiring blood pressure lowering?
Meta-Analysis (n=2,459)
Does fimasartan reduce blood pressure more effectively than comparators in patients requiring blood pressure lowering?
Effect estimate: MD -2.58 mm Hg (95% CI -4.35 to -0.81)
p-value: p=0.004
Fimasartan provides significantly greater blood pressure reduction compared to other antihypertensive agents, including other ARBs.
Supports fimasartan for modestly greater systolic BP reduction; confirms superiority versus comparators in pooled trials.
PURPOSE: Fimasartan, one of the newest angiotensin receptor blockers (ARBs) available worldwide, has been investigated extensively since its initial development. Our study group conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating fimasartan and comparators for their blood pressure (BP)-lowering effect. Moreover, we employed a cross-inference (frequentist and Bayesian inference) system, which has never been used in the medical field, to confirm the results of our study. In addition, a quality management system was integrated throughout the study for data quality. METHODS: ) and 95% CIs were identified for reductions in clinic sitting systolic and diastolic BP (SiSBP/SiDBP) or 24-hour mean systolic BP and diastolic BP by ambulatory BP monitoring (ASBP/ADBP) from baseline between the fimasartan and comparator groups, followed by meta-analysis. A subsequent meta-analysis was performed with frequentist and Bayesian inference as a tool in the cross-checking system. FINDINGS: Eleven RCTs with a total of 2459 subjects were included in the study. The clinic SiSBP/SiDBP-lowering effect of fimasartan was significantly greater relative to those of comparators (MD for clinic SiSBP, -2.58 mm Hg [95% CI, -4.35 to -0.81; P = 0.004]; MD for clinic SiDBP, -2.13 mm Hg [95% CI, -2.96 to -1.30; P = 0.00001]). The ASBP/ADBP-lowering effect of fimasartan was also significantly greater relative to those of comparators (MD for ASBP, -3.58 mm Hg [95% CI, -5.74 to -1.43; P = 0.001]; MD for ADBP, -1.99 mm Hg [95% CI, -3.34 to -0.63; P = 0.004]). IMPLICATIONS: Fimasartan seems to be more effective in lowering BP than its comparators, including other ARBs. Although there is a limited amount of data and a minuscule number of study subjects available, the results of cross-inference (frequentist + Bayesian) were fairly consistent with the meta-analysis results through our quality management system.
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Oh et al. (2023) conducted a meta-analysis in High blood pressure (n=2,459). Fimasartan vs. Comparators was evaluated on Reduction in clinic sitting systolic blood pressure (SiSBP) from baseline (MD -2.58 mm Hg, 95% CI -4.35 to -0.81, p=0.004). Fimasartan significantly reduced clinic sitting systolic blood pressure compared to comparators (MD -2.58 mm Hg; 95% CI -4.35 to -0.81; P=0.004).
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