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Rind L, Mahmood T, Siddiqui MH, Ahsan F, Shamim A, Anwar A, Yadav RK. From Hypertension to Beyond: Unraveling the Diverse Mechanisms of Olmesartan in Disease Modulation. Drug Res (Stuttg) 2024; 74:93-101. [PMID: 38350635 DOI: 10.1055/a-2244-3136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Olmesartan, originally known for its antihypertensive properties, exhibits promising potential in addressing inflammation-mediated diseases. As an angiotensin II receptor blocker (ARB), Olmesartan influences pivotal pathways, including reactive oxygen species, cytokines, NF-κB, TNF-α, and MAPK. This suggests a viable opportunity for repurposing the drug in conditions such as ulcerative colitis, neuropathy, nephropathy, and cancer, as supported by multiple preclinical studies. Ongoing clinical trials, particularly in cardiomyopathy and nephropathy, suggest a broader therapeutic scope for Olmesartan. Repurposing efforts would entail comprehensive investigations using disease-specific preclinical models and dedicated clinical studies. The drug's established safety profile, wide availability, and well-understood ARB mechanism of action offer distinct advantages that could facilitate a streamlined repurposing process. In summary, Olmesartan's versatile impact on inflammation-related pathways positions it as a promising candidate for repurposing across various diseases. Ongoing clinical trials and the drug's favorable attributes enhance its appeal for further exploration and potential application in diverse medical contexts.
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Affiliation(s)
- Laiba Rind
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
- Department of Pharmacology, Era College of Pharmacy, Era University, Lucknow, India
| | - Tarique Mahmood
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
| | | | - Farogh Ahsan
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
| | - Arshiya Shamim
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
| | - Aamir Anwar
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, India
| | - Rajnish Kumar Yadav
- Department of Pharmacology, Era College of Pharmacy, Era University, Lucknow, India
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Cui Z, Qiu Z, Cheng W, Hu W, Ma G, Cai X, Jin Y, Zhao Y, He L, Li Y, Bu P, Chen X, Wang R, Chen L, Dong P, Feng L, Han X, Hong M, Hou Y, Liao M, Wang M, Wang X, Xie J, Xu Y, Wang Z, Huang K, Li Y, Li D, Ji X, Huang J, Wang J, Fang D, Wang J, Tang L, Liu Y, Fu G, Du J, Wang L, Liu M, Ge J. Efficacy and safety of olmesartan medoxomil-amlodipine besylate tablet in Chinese patients with essential hypertension: A prospective, single-arm, multi-center, real-world study. J Clin Hypertens (Greenwich) 2024; 26:5-16. [PMID: 37667532 PMCID: PMC10795096 DOI: 10.1111/jch.14700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 09/06/2023]
Abstract
There lacks real-world study with a large sample size assessing olmesartan medoxomil-amlodipine besylate (OM-AML) tablet. Therefore, this study aimed to evaluate the efficacy and safety of OM-AML tablet in patients with essential hypertension. Totally, 1341 patients from 36 medical centers with essential hypertension who took OM-AML (20/5 mg) tablet were analyzed in the current prospective, single-arm, multi-center, real-world study (SVK study). Seated systolic blood pressure (SeSBP) and seated diastolic blood pressure (SeDBP) at baseline, week (W)4 and W8 were measured. The mean (±SE) change of SeSBP/SeDBP was -10.8 ± 0.4/-6.6 ± 0.3 mmHg at W4 and -12.7 ± 0.5/-7.6 ± 0.3 mmHg at W8, respectively. At W4, 78.8% and 29.0% patients achieved BP target by China and American Heart Association (AHA) criteria; at W8, 84.7% and 36.5% patients reached blood pressure (BP) target by China and AHA criteria, accordingly. Meanwhile, 80.2% and 86.4% patients achieved BP response at W4 and W8, respectively. Home-measured SeSBP and SeDBP decreased from W1 to W8 (both p < .001). Besides, patients' and physicians' satisfaction were elevated at W8 compared with W0 (both p < .001). The medication possession rate was 94.8% from baseline to W4 and 91.3% from baseline to W8. The most common drug-related adverse events were nervous system disorders (4.6%), vascular disorders (2.6%), and general disorders and administration site conditions (2.3%) by system organ class, which were generally mild and manageable. In conclusion, OM-AML tablet is one of the best antihypertensive agents in patients with essential hypertension.
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Affiliation(s)
- Zhaoqiang Cui
- Department of CardiologyZhongshan Hospital, Fudan UniversityShanghaiChina
| | - Zhaohui Qiu
- Department of CardiologyShanghai Tongren HospitalShanghaiChina
| | - Wenli Cheng
- Department of CardiologyBeijing Anzhen Hospital, Capital Medical UniversityBeijingChina
| | - Wei Hu
- Department of CardiologyCentral Hospital of Minhang DistrictShanghaiChina
| | - Genshan Ma
- Department of CardiologyZhongda Hospital Affiliated to Southeast UniversityNanjingChina
| | - Xiaojun Cai
- Department of CardiologyJinan Central HospitalJinanChina
| | - Yafei Jin
- Department of CardiologyThe First Affiliated Hospital of Sun Yat‐sen UniversityGuangzhouChina
| | - Yi Zhao
- Department of CardiologyDalian Jinzhou First People's HospitalDalianChina
| | - Liqun He
- Department of CardiologyWuhan No. 1 HospitalWuhanChina
| | - Ying Li
- Department of CardiologyShanghai East HospitalShanghaiChina
| | - Peili Bu
- Department of CardiologyQilu Hospital of Shandong UniversityJinanChina
| | - Xiaoping Chen
- Department of CardiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Ruxing Wang
- Department of CardiologyWuxi People's HospitalWuxiChina
| | - Lin Chen
- Department of CardiologyThird Affiliated Hospital of Sun Yat‐Sen UniversityGuangzhouChina
| | - Peng Dong
- Department of CardiologyBeijing Aviation General HospitalBeijingChina
| | - Liuliu Feng
- Department of CardiologyShidong Hospital, Yangpu DistrictShanghaiChina
| | - Xuebin Han
- Department of CardiologyShanxi Cardiovascular Hospital (Shanxi Cardiovascular Diseases Institute)TaiyuanChina
| | - Mei Hong
- Department of CardiologyThe Second Clinical Medical College of Nanjing Medical UniversityNanjingChina
| | - Yinglong Hou
- Department of CardiologyThe First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan HospitalJinanChina
| | - Minlei Liao
- Department of CardiologyBaoshan Branch, Shanghai General HospitalShanghaiChina
| | - Mingliang Wang
- Department of CardiologyPutuo People's Hospital, Tongji UniversityShanghaiChina
| | - Xiaoyan Wang
- Department of CardiologyWuxi Third People's HospitalWuxiChina
| | - Jianhong Xie
- Department of CardiologyZhejiang Provincial People's HospitalHangzhouChina
| | - Yawei Xu
- Department of CardiologyShanghai Tenth People's HospitalShanghaiChina
| | - Zhenxing Wang
- Department of CardiologyJiangsu Province Hospital of Chinese MedicineNanjingChina
| | - Kai Huang
- Department of CardiologyUnion Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina
| | - Yongle Li
- Department of CardiologyTianjin Medical University General HospitalTianjinChina
| | - Dongsheng Li
- Department of CardiologyWuhan Third HospitalWuhanChina
| | - Xiaojun Ji
- Department of CardiologyWenzhou Central HospitalWenzhouChina
| | - Jing Huang
- Department of CardiologyThe Second Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Jun Wang
- Department of CardiologyJing'an District Central Hospital of ShanghaiShanghaiChina
| | - Danhong Fang
- Department of CardiologyThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
| | - Jian'an Wang
- Department of CardiologyThe Second Affiliated Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Lijiang Tang
- Department of CardiologyZhejiang HospitalHangzhouChina
| | - Yingwu Liu
- Department of CardiologyTianjin Third Central HospitalTianjinChina
| | - Guosheng Fu
- Department of CardiologySir Run Run Shaw Hospital of Zhejiang University School of MedicineHangzhouChina
| | - Juan Du
- Medical DepartmentDaiichi Sankyo (China) Holdings Co., LtdShanghaiChina
| | - Ling Wang
- Medical DepartmentDaiichi Sankyo (China) Holdings Co., LtdShanghaiChina
| | - Mengqi Liu
- Medical DepartmentDaiichi Sankyo (China) Holdings Co., LtdShanghaiChina
| | - Junbo Ge
- Department of CardiologyZhongshan Hospital, Fudan UniversityShanghaiChina
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Xu M, Zhang X, Ye R, Liu X, Sun L, Jia S, Zhang Z, Li X, Wang Z, Liao H, Shi R, Liu K, Wang S, Meng Q, Chen X. The effects of Olmesartan/amlodipine administered in the Morning or At Night on nocturnal blood pressure reduction in Chinese patients with mild-moderate essential hypertension (OMAN Trial): study protocol for a prospective, multicenter, randomized, open-label clinical trial {1}. Trials 2023; 24:770. [PMID: 38017457 PMCID: PMC10685633 DOI: 10.1186/s13063-023-07726-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 10/12/2023] [Indexed: 11/30/2023] Open
Abstract
INTRODUCTION Hypertension increases the risk of cardiovascular disease. Uncontrolled nocturnal blood pressure is prevalent in patients taking antihypertensive medication, with an incidence rate of 30-60%. Although chronotherapy with antihypertensive agents may provide a new direction for effective control of nocturnal blood pressure, the clinical evidence base remains controversial. This research is presently underway to compare the effects of morning and bedtime administration of antihypertensive medication on nocturnal reduction and circadian rhythm of blood pressure in patients with hypertension. METHODS AND ANALYSIS This study is being performed as a randomized, multicenter, open-label, parallel-group, clinical trial in which 720 participants are to undergo 24-h ambulatory blood pressure measurement (ABPM) and office blood pressure measurement (OBPM) at baseline before being randomly assigned to a morning (6-10 am) or a bedtime (6-10 pm) administration group. Each participant receives one 20/5-mg tablet of olmesartan/amlodipine (OA) daily for 4 weeks and is then followed up at 4-week intervals for a total of 12 weeks. During follow-up, the OA dosage is adjusted according to the ABPM and OBPM results. Patients with uncontrolled hypertension at the first follow-up visit will receive an increase in OA dosage to 1.5 tablets/day. For patients with blood pressure that is still uncontrolled after a further 4 weeks, the dosage of OA can be increased to 2 tablets/day. The primary objective is the reduction in mean nocturnal systolic blood pressure between baseline and week 12. The secondary objectives are the reduction in ambulatory blood pressure at weeks 4 and 12 and the blood pressure control rate at weeks 4, 8, and 12. DISCUSSION Antihypertensive chronotherapy remains controversial. A superiority test hypothesis design has been adopted for this trial, in which all participants will be taking the same antihypertensive medication. We anticipate that our findings will determine if nocturnal blood pressure control in Chinese patients with essential hypertension varies according to whether antihypertensive medication is taken in the morning or at bedtime. This study may provide scientific evidence for the application of chronotherapy in clinical practice. TRIAL REGISTRATION ChiCTR2200059719. Registered on 10 May 2022 ( http://www.chictr.org.cn/edit.aspx?pid=169782&htm=4 ) {2a,2b}.
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Affiliation(s)
- Mengzhuo Xu
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xin Zhang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Runyu Ye
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xueting Liu
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Lirong Sun
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Shanshan Jia
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Zhipeng Zhang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Xinran Li
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Ziqiong Wang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Hang Liao
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Rufeng Shi
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Kai Liu
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Si Wang
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Qingtao Meng
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
| | - Xiaoping Chen
- Cardiology Department, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China.
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Pharmacodynamic model of slow reversible binding and its applications in pharmacokinetic/pharmacodynamic modeling: review and tutorial. J Pharmacokinet Pharmacodyn 2022; 49:493-510. [PMID: 36040645 PMCID: PMC9578295 DOI: 10.1007/s10928-022-09822-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/12/2022] [Indexed: 10/14/2022]
Abstract
Therapeutic responses of most drugs are initiated by the rate and degree of binding to their receptors or targets. The law of mass action describes the rate of drug-receptor complex association (kon) and dissociation (koff) where the ratio koff/kon is the equilibrium dissociation constant (Kd). Drugs with slow reversible binding (SRB) often demonstrate delayed onset and prolonged pharmacodynamic effects. This report reviews evidence for drugs with SRB features, describes previous pharmacokinetic/pharmacodynamic (PK/PD) modeling efforts of several such drugs, provides a tutorial on the mathematics and properties of SRB models, demonstrates applications of SRB models to additional compounds, and compares PK/PD fittings of SRB with other mechanistic models. We identified and summarized 52 drugs with in vitro-confirmed SRB from a PubMed literature search. Simulations with a SRB model and observed PK/PD profiles showed delayed and prolonged responses and that increasing doses/kon or decreasing koff led to greater expected maximum effects and a longer duration of effects. Recession slopes for return of responses to baseline after single doses were nearly linear with an inflection point that approaches a limiting value at larger doses. The SRB model newly captured literature data for the antihypertensive effects of candesartan and antiallergic effects of noberastine. Their PD profiles could also be fitted with indirect response and biophase models with minimal differences. The applicability of SRB models is probably commonplace, but underappreciated, owing to the need for in vitro confirmation of binding kinetics and the similarity of PK/PD profiles to models with other mechanistic determinants.
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