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| |  Atacand More Effective Than Cozaar In Reducing Diastolic BP WAYNE, PA -- Aug. 17, 1999 -- Findings of the CANDLE (CANDesartan versus Losartan Efficacy comparison) study show that AstraZeneca LP’s Atacand(R) (candesartan cilexetil), an angiotensin receptor blocker (ARB) recently introduced in the United States, provided a significantly greater reduction in diastolic blood pressure (DBP) than the most commonly prescribed ARB, Merck & Co., Inc.’s Cozaar(R) (losartan). The results are published in the current issue of the medical journal Heart Disease. In the eight-week CANDLE study, a total of 332 patients received either of the study drugs, with 309 patients completing the study. The candesartan regimen provided a significantly greater reduction of trough sitting DBP at week eight (11.0 mmHg versus 8.9 mmHg) than did the losartan regimen. Candesartan also produced numerically greater, but not statistically significant reductions in secondary blood pressure parameters, including sitting systolic blood pressure (SBP), trough standing DBP and SBP. Responder rates (sitting DBP less than 90 mmHg or reduction in blood pressure of greater than or equal to 10 mmHg) and control rates (sitting DBP less than 90 mmHg) were 64 percent versus 54 percent and 54 percent versus 43 percent, respectively with candesartan versus losartan. A total of 1.2 percent of the patients taking candesartan and 3.2 percent of those taking losartan discontinued prematurely because of adverse events. The most frequent adverse events reported in patients taking Atacand in CANDLE were headache, upper respiratory tract infections, back pain and fatigue. The overall incidence of adverse events has been similar to placebo in this and other controlled clinical trials. Adverse events that have occurred in at least one percent of patients treated with Atacand and were higher in frequency than placebo included back pain, dizziness, upper respiratory tract infection, pharyngitis (sore throat) and rhinitis. As with other drugs that act directly on the renin-angiotensin system, ARBs should not be used by pregnant women and should be discontinued if pregnancy is detected. CANDLE was conducted at 40 centres across the U.S. using the usual recommended starting and maximum once-daily doses of Atacand (16, 32 mg once a day) and Cozaar (50, 100 mg once a day) in patients with an entry sitting diastolic blood pressure (DBP) of 95-114 mmHg. Those studied were a typical cross-section of the hypertensive population and the titration-to-effect design mimicked methods used by practising physicians to determine drug dosage in individual patients. Patients were started at the lower dose and escalated to the higher dose if their seated diastolic blood pressure had not fallen to below 90 mmHg after the fourth week of treatment. Participation in the study was open to male and female patients with hypertension aged 18 to 80 years. The average age was 55 years. Hypertension, defined as a blood pressure of 140/90 mmHg or higher, is a relatively frequent condition affecting approximately 40 million Americans. It is called the silent killer because it usually causes no symptoms. However, hypertension is a major risk factor for death and disability related to coronary heart disease, heart attacks, heart failure, strokes, kidney disease and vascular complications. Commonly-accepted guidelines call for a physician to initially recommend appropriate lifestyle changes to lower blood pressure in these patients unless they have a coexisting disease such as diabetes, in which case patients with even lower levels are treated with medication. Because most hypertensive patients have no symptoms, many do not take their medications due to the unwanted side effects of some therapies.
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