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December 23, 2009Expert Opinion on Pharmacotherapy

Differences in pharmacology and their translation into differences in clinical efficacy – a comparison of the renin angiotensin blocking agents irbesartan and losartan

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Key result

Irbesartan provided a greater and longer-lasting antihypertensive effect and was more effective in preventing kidney function deterioration in diabetic nephropathy compared to losartan.

Why the study?

Does irbesartan improve clinical efficacy and end-organ protection compared to losartan in patients with hypertension and diabetic nephropathy?

Population

Patients with hypertension and diabetic nephropathy

Comparison

Irbesartan vs Losartan

Design

Review

Authors

PBPeter BramlagePreventive CardiologyCSChristoph SchindlerMedizinische Hochschule Hannover

Discussion

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Implication

May support irbesartan preference in diabetic nephropathy; leaves open confirmation by head-to-head RCTs.

Structured PICO

Does irbesartan improve clinical efficacy and end-organ protection compared to losartan in patients with hypertension and diabetic nephropathy?

P
Population
Patients with hypertension and diabetic nephropathy (also mentions left ventricular hypertrophy, heart failure, and atrial fibrillation)
I
Intervention
Irbesartan
C
Comparator
Losartan
O
Outcome
Blood-pressure-lowering efficacy, tolerability/safety, end-organ protective effects, and economic evaluation

Irbesartan demonstrates incremental clinical and economic benefits over losartan in the treatment of hypertension and diabetic nephropathy.

Limitations

  • There is only one end point trial for either drug in patients with left ventricular hypertrophy, heart failure and atrial fibrillation, but no direct comparison.

Cite This Study

Bramlage et al. (2009) conducted a review in Hypertension and diabetic nephropathy. Irbesartan vs. Losartan was evaluated on Blood-pressure-lowering efficacy and end-organ protective effects. Irbesartan provided a greater and longer-lasting antihypertensive effect and was more effective in preventing kidney function deterioration in diabetic nephropathy compared to losartan.

synapsesocial.com/papers/6a2312fd6bcfca2a0e1ce8cchttps://doi.org/10.1517/14656560903512962

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative Efficacy of Two Angiotensin II Receptor Antagonists, Irbesartan and Losartan, in Mild-to-Moderate Hypertension1998 · 170 citations
  2. 2Comparison of angiotensin II receptor antagonists2001 · 31 citations
  3. 3Comparative Effects of Irbesartan Versus Amlodipine on Left Ventricular Mass Index in Hypertensive Patients with Left Ventricular Hypertrophy2003 · 34 citations
  4. 4The Effect of Irbesartan on the Development of Diabetic Nephropathy in Patients with Type 2 Diabetes2001 · 2,905 citations
  5. 5Prevention of recurrences in patients with lone atrial fibrillation. The dose-dependent effect of angiotensin II receptor blockers2004 · 78 citations