Effects of telmisartan on fat distribution: a meta-analysis of randomized controlled trials

Choi, Geun Joo; Kim, Hyun Min; Kang, Hyun; Kim, Jaetaek

doi:10.1185/03007995.2016.1171204

Cited by 12 publications

(8 citation statements)

References 62 publications

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“…Interestingly, ARBs, including telmisartan, have been shown to reduce body weight, as found in this study ( Fig. 1 B) and adipose tissue 35 , 36 and, furthermore, reduction of body weight and adipose tissue is associated with lowering of IOP. 37 , 38 However, the similarity of IOP responses to bead injection argues against IOP-mediated effects of weight loss or BP lowering as contributing to the observed neuroprotection.…”

Section: Discussionsupporting

confidence: 78%

Telmisartan Reduces Axon Degeneration in Mice With Experimental Glaucoma

Hazlewood

Kuchtey

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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The purpose of this study was to determine if treatment with telmisartan, an angiotensin II type 1 receptor blocker (ARB), protects against retinal ganglion cell (RGC) degeneration in a mouse glaucoma model with induced elevation of intraocular pressure (IOP). METHODS. IOP elevation was induced by injection of polystyrene microbeads into the anterior chamber of the right eye of 3-month-old C57BL/6J mice, with the left eye serving as contralateral control. Starting the day of microbead injection, mice were maintained on solid food pellets with or without incorporated telmisartan. IOP was measured by Tono Lab tonometry prior to and weekly after microbead injection. Twelve weeks postinjection, mice were euthanized to obtain optic nerves for analysis of RGC axons. The total numbers of optic nerve axons were determined manually and automatedly using AxonJ. Degenerating axons were counted manually. RESULTS. IOP elevation induced by microbead injection was similar in magnitude and duration in vehicle and telmisartan-fed mice, although IOP was reduced 5.8% in uninjected mice treated with telmisartan (P = 0.0027). Axon loss determined by manual and automated methods was greater in vehicle compared to telmisartan-treated mice (manual: 9.5% vs. 1.8%, P = 0.044; automated: 14.2% vs. 2.9%, P = 0.0375). An increase in the percent of axons undergoing degeneration was observed in nerves from microbeadinjected eyes that was greater in vehicle-treated compared to telmisartan-treated mice (49.0% vs.-0.58%, P = 0.0019). CONCLUSIONS. Elevation of IOP by microbead injection led to loss of RGC axons in vehicletreated mice that was largely prevented by telmisartan treatment, suggesting a neuroprotective effect of telmisartan.

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Section: Discussionsupporting

confidence: 78%

Telmisartan Reduces Axon Degeneration in Mice With Experimental Glaucoma

Hazlewood

Kuchtey

et al. 2020

Invest. Ophthalmol. Vis. Sci.

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“…The pharmacological actions of telmisartan did not influence by the gender (26). The possible explanation of the effect of telmisartan on the waist circumference is telmisartan induced changes in the fat distribution, and thereby it reduced the visceral obesity (27). Placebo-treated patients showed a significant improvement in the lipid profile, which can be attributed to the diet modifying regimen.…”

Section: Discussionmentioning

confidence: 88%

Telmisartan improves the metabolic, hematological and inflammasome indices in non-alcoholic fatty liver infiltration: A pilot open-label placebo-controlled study

2019

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“…A limited meta-analysis of three RCTs 83 with telmisartan treatment duration of 16-24 weeks (combined sample size of 62 participants) showed that telmisartan caused a significant reduction in visceral, but not in subcutaneous, fat suggesting a beneficial effect on body fat. However, the current study did not observe any significant reduction in internal visceral fat with any of the telmisartan doses over a period of 24 weeks.…”

Section: Telmisartan Significantly Reduced Liver Fat But Not Total Bmentioning

confidence: 99%

Telmisartan to reduce insulin resistance in HIV-positive individuals on combination antiretroviral therapy: the TAILoR dose-ranging Phase II RCT

et al. 2019

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Background Combination antiretroviral therapy (cART) is the standard for human immunodeficiency virus (HIV) infection treatment but can result in metabolic abnormalities, such as insulin resistance, dyslipidaemia and lipodystrophy, which can increase the risk of cardiovascular disease. Objective The objective of the trial was to evaluate whether or not telmisartan, an angiotensin II receptor antagonist and a peroxisome proliferator-activated receptor-γ partial agonist, could reduce insulin resistance in HIV-positive individuals on cART, and affect blood and imaging biomarkers of cardiometabolic disease. Design A Phase II, multicentre, randomised, open-labelled, dose-ranging trial of telmisartan over a period of 48 weeks with an adaptive design comprising two stages was used to identify the optimal dose of telmisartan. Participants were randomised to receive one of the three doses of telmisartan (20, 40 and 80 mg) or no intervention (control). Setting Recruitment was from 19 HIV specialist centres in the UK. Participants A total of 377 patients infected with HIV who met the prespecified inclusion/exclusion criteria. Interventions 20-, 40- and 80-mg tablets of telmisartan. Main outcome measures The primary outcome measure was reduction in the homeostatic model assessment of insulin resistance (HOMA-IR), a marker of insulin resistance, at 24 weeks. Secondary outcome measures were changes in plasma lipid profile; Quantitative Insulin Sensitivity Check Index (QUICKI) and revised QUICKI, alternative markers of insulin resistance, plasma adipokines (adiponectin, leptin, interleukin 8, tumour necrosis factor alpha, resistin); high-sensitivity C-reactive protein (hs-CRP); body fat redistribution, as measured by magnetic resonance imaging/proton magnetic resonance spectroscopy; changes in renal markers (albumin-to-creatinine ratio, neutrophil gelatinase-associated lipocalin); and tolerability to telmisartan. Results At the interim analysis, 80 mg of telmisartan was taken forward into the second stage of the study. Baseline characteristics were balanced across treatment arms. There were no differences in HOMA-IR [0.007, standard error (SE) 0.106], QUICKI (0.001, SE 0.001) and revised QUICKI (0.002, SE 0.002) at 24 weeks between the telmisartan (80 mg; n = 106) and non-intervention (n = 105) arms. Longitudinal analysis over 48 weeks showed that there was no change in HOMA-IR, lipid or adipokine levels; however, but there were significant, but marginal, improvements in revised QUICKI [0.004, 95% confidence interval (CI) 0.000 to 0.008] and plasma hs-CRP (–0.222, 95% CI –0.433 to –0.011) over 48 weeks. Substudies also showed a significant reduction in the liver fat content at 24 weeks (1.714, 95% CI –2.787 to –0.642; p = 0.005) and urinary albumin excretion at 48 weeks (–0.665, 95% CI –1.31 to –0.019; p = 0.04). There were no differences in serious adverse events between the telmisartan and control arms. Limitations The patients had modest elevations of HOMA-IR at baseline, and our trial could have been under-powered to detect smaller improvements in insulin resistance over time. Conclusions Using a novel adaptive design, we demonstrated that there was no significant effect of telmisartan (80 mg) on the primary outcome measure of HOMA-IR and some secondary outcomes (plasma lipids and adipokines). Telmisartan did lead to favourable, and biologically plausible, changes of the secondary longitudinal outcome measures: revised QUICKI, hs-CRP, hepatic fat accumulation and urinary albumin excretion. Taken collectively, our findings showed that telmisartan did not reduce insulin resistance in patients infected with HIV on antiretrovirals. Future work The mechanistic basis of adipocyte regulation will be studied to allow for development of biomarkers and interventions. Trial registration Current Controlled Trials ISRCTN51069819. Funding This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a Medical Research Council and National Institute for Health Research partnership.

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Effects of telmisartan on fat distribution: a meta-analysis of randomized controlled trials

Abstract: The findings suggest that telmisartan affected fat distribution, inducing visceral fat reduction, and thus could be useful in hypertensive patients with obesity/overweight, metabolic syndrome, or glucose intolerance.

Cited by 12 publications

References 62 publications

Telmisartan Reduces Axon Degeneration in Mice With Experimental Glaucoma

Telmisartan Reduces Axon Degeneration in Mice With Experimental Glaucoma

Telmisartan improves the metabolic, hematological and inflammasome indices in non-alcoholic fatty liver infiltration: A pilot open-label placebo-controlled study

Telmisartan to reduce insulin resistance in HIV-positive individuals on combination antiretroviral therapy: the TAILoR dose-ranging Phase II RCT

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