Antihypertensive effectiveness of aliskiren for the ‘real-world’ management of hypertension: multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study)

Verpooten, Gert A.; Aerts, Ann; Coen, Nicolas; Vancayzeele, Stefaan; Hermans, Christine; Bowles, John; MacDonald, Karen; Abraham, Ivo; Lee, Christopher S.

doi:10.1111/j.1742-1241.2010.02562.x

Cited by 14 publications

(24 citation statements)

References 43 publications

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“…A recent 24-week, open-label, single-arm study showed that the combination therapy of aliskiren and a RAAS blocker in CKD patients who were already being treated with ACE-is or ARBs for more than six months had a favorable effect on reducing residual proteinuria and BP reduction. 44 Another recent study 43 confirmed the efficacy and safety of aliskiren in a real-life setting. Aliskiren is approved for treatment of hypertension, but has also shown renoprotective potential in normotensive patients with T2DM and albuminuria.…”

Section: Discussionmentioning

confidence: 92%

“…However, our results are in agreement with the findings of other clinical trials. [42][43][44] An eight-week, double-blind, multicentre trial 45 assessed whether the combination of aliskiren and ramipril in patients with diabetes and hypertension was safe and effective in lowering BP when compared with the respective monotherapies. In this study aliskiren showed higher SBP reduction with ramipril.…”

Section: Discussionmentioning

confidence: 99%

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Combination therapy with aliskiren versus ramipril or losartan added to conventional therapy in patients with type 2 diabetes mellitus, uncontrolled hypertension and microalbuminuria

Imbalzano

Scarpelli

Mandraffino

et al. 2014

J Renin Angiotensin Aldosterone Syst

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Hypothesis/Introduction: The aim of this study was to assess the antihypertensive efficacy and safety of aliskiren versus ramipril or losartan in hypertensive patients with type 2 diabetes mellitus, microalbuminuria and uncontrolled hypertension, despite the use of optimal conventional antihypertensive therapy. Materials and methods: In this open-label active comparator study, 126 patients were randomly assigned to receive 24 weeks of additional therapy with aliskiren (Group A) or either losartan or ramipril (Group B), according to whether a patient was already treated with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker, respectively. Results: After 24 weeks, both treatment groups experienced a significant reduction of systolic blood pressure (−11.37% and −8.47%, respectively; both p <0.001 vs. baseline) and diastolic blood pressure levels (−10.67% and −9.28%, respectively; both p <0.001 vs. baseline), with a greater reduction of mean systolic values in Group A compared with Group B (p <0.001). Furthermore, after six months microalbuminuria was significantly decreased in both treatment groups (−67.62% and −49.1%, respectively; both p <0.001), with a reduction rate in Group A significantly higher than in Group B (p<0.001). Conclusions: The addition of aliskiren to optimal conventional therapy provided a higher reduction of blood pressure and urinary albumin excretion when compared with the addition of losartan or ramipril.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Combination therapy with aliskiren versus ramipril or losartan added to conventional therapy in patients with type 2 diabetes mellitus, uncontrolled hypertension and microalbuminuria

Imbalzano

Scarpelli

Mandraffino

et al. 2014

J Renin Angiotensin Aldosterone Syst

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“…At the end of treatment, mean SBP/SDP reductions were 22.9 ± 16.7/10.5 ± 10.9 mm Hg ( p < 0.001). Adequate BP control based on 2009 guidelines was achieved by 56.3% of patients ( p < 0.001) and 64.2% of eligible patients had a CV risk reduction [92]. In data derived from the Italian web-based drug-monitoring system, ALI prescribed in patients with uncontrolled BP and organ damage or comorbidities produced lower SBP/DBP measurements consistently on follow-up visits, and very few reported AEs [93].…”

Section: Aliskiren and Blood Pressure Loweringmentioning

confidence: 99%

Renin Inhibition with Aliskiren: A Decade of Clinical Experience

Pantzaris

Karanikolas

Tsiotsios

et al. 2017

JCM

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The renin-angiotensin-aldosterone system (RAAS) plays a key role in the pathophysiology of arterial hypertension as well as in more complex mechanisms of cardiovascular and renal diseases. RAAS-blocking agents like angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers, have long been key components in the treatment of essential hypertension, heart failure, diabetic nephropathy, and chronic kidney disease, showing benefits well beyond blood pressure reduction. Renin blockade as the first step of the RAAS cascade finally became possible in 2007 with the approval of aliskiren, the first orally active direct renin inhibitor available for clinical use and the newest antihypertensive agent on the market. In the last decade, many clinical trials and meta-analyses have been conducted concerning the efficacy and safety of aliskiren in comparison to other antihypertensive agents, as well as the efficacy and potential clinical use of various combinations. Large trials with cardiovascular and renal endpoints attempted to show potential benefits of aliskiren beyond blood pressure lowering, as well as morbidity and mortality outcomes in specific populations such as diabetics, heart failure patients, and post-myocardial infarction individuals. The purpose of this review is to present the currently available data regarding established and future potential clinical uses of aliskiren.

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“…Furthermore, in 2007, the FDA approved Aliskiren, a first-in-class direct renin inhibitor representing the first novel therapeutic anti-hypertensive class approved by the agency in thirteen years. Although results from three clinical trials and several observational studies supported Aliskiren’s effectiveness in reducing blood pressure [7,8,9,10,11,12], evidence also suggests Aliskiren is associated with higher rates of adverse events compared with placebo in diabetic patients concomitantly treated with ARBs or ACE inhibitors [13]. …”

Section: Introductionmentioning

confidence: 99%

National Trends in the Ambulatory Treatment of Hypertension in the United States, 1997-2012

et al. 2015

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ImportanceHypertension is common and costly. Over the past decade, new antihypertensive therapies have been developed, several have lost patent protection and additional evidence regarding the safety and effectiveness of these agents has accrued.ObjectiveTo examine trends in the use of antihypertensive therapies in the United States between 1997 and 2012.Design, Setting and ParticipantsWe used nationally representative audit data from the IMS Health National Disease and Therapeutic Index to examine the ambulatory pharmacologic treatment of hypertension.Outcome MeasuresOur primary unit of analysis was a visit where hypertension was a reported diagnosis and treated with a pharmacotherapy (treatment visit). We restricted analyses to the use of six therapeutic classes of antihypertensive medications among individuals 18 years or older.ResultsAnnual hypertension treatment visits increased from 56.9 million treatment visits (95% confidence intervals [CI], 53.9–59.8) in 1997 to 83.3 million visits (CI 79.2–87.3) in 2008, then declined steadily to 70.9 million visits (CI 66.7–75.0) by 2012. Angiotensin receptor blocker utilization increased substantially from 3% of treatment visits in 1997 to 18% by 2012, whereas calcium channel blocker use decreased from 27% to 18% of visits. Rates of diuretic and beta-blocker use remained stable and represented 24%–30% and 14–16% of visits, respectively. Use of direct renin inhibitor accounted for fewer than 2% of annual visits. The proportion of visits treated using fixed-dose combination therapies increased from 28% to 37% of visits.ConclusionsSeveral important changes have occurred in the landscape of antihypertensive treatment in the United States during the past decade. Despite their novel mechanism of action, the adoption rate of direct renin inhibitors remains low.

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Antihypertensive effectiveness of aliskiren for the ‘real-world’ management of hypertension: multilevel modelling of 180-day blood pressure outcomes (the Belgian DRIVER Study)

Cited by 14 publications

References 43 publications

Combination therapy with aliskiren versus ramipril or losartan added to conventional therapy in patients with type 2 diabetes mellitus, uncontrolled hypertension and microalbuminuria

Combination therapy with aliskiren versus ramipril or losartan added to conventional therapy in patients with type 2 diabetes mellitus, uncontrolled hypertension and microalbuminuria

Renin Inhibition with Aliskiren: A Decade of Clinical Experience

National Trends in the Ambulatory Treatment of Hypertension in the United States, 1997-2012

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