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Villegas-Quintero VE, Rivas-Ruíz R, García-Rivero AA, Rivera-Lara P, González-Tovar NB. [Efficacy and safety of atorvastatin in major cardiovascular events: Meta-analysis]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2023; 61:S407-S415. [PMID: 37934798 PMCID: PMC10735271 DOI: 10.5281/zenodo.8319748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/01/2023] [Indexed: 11/09/2023]
Abstract
Introduction Atorvastatin has been used in the management of dyslipidemia and little is known about the efficacy and safety of high-dose atorvastatin administration for secondary prevention of Major Cardiovascular Events (MACE). Objective To evaluate the impact of high-dose atorvastatin on secondary prevention of MACE and adverse events. Material and methods A systematic review and meta-analysis of Pubmed, Embase, Bireme and Cochrane Library Plus databases was performed, with a time scope from 1990 to July 2022. Six randomized clinical trials were included with a total of 29,333 patients who were treated with 80 mg, 10 mg or placebo doses of Atorvastatin where the main outcomes evaluated were Major Cardiovascular Events (MACE), mortality and treatment safety. Results In the comparative study between the use of Atorvastatin 80 mg and other therapies, a relative risk (RR) of 0.8 (95%CI 0.69-0.92) was found, representing a 20% reduction in risk (RRR) and a number needed to treat (NNT) of 30-55. In the analysis of adverse effects, an RR of 2.37 (95% CI 0.86-6.53) and a number needed to harm (NNH) of 14-19 were observed. The use of 80 mg atorvastatin is associated with similar adverse events at lower doses. Conclusions The use of atorvastatin 80 mg is effective in the secondary prevention of Major Cardiovascular Event (MACE). The drug has adverse events that should be taken into account in secondary prevention.
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Affiliation(s)
- Víctor Eder Villegas-Quintero
- Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud, Centro de Adiestramiento en investigación Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Rodolfo Rivas-Ruíz
- Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud, Centro de Adiestramiento en investigación Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Alexis Alejandro García-Rivero
- Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud, Centro de Adiestramiento en investigación Clínica. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Pedro Rivera-Lara
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Hospital de Cardiología, Servicio de Urgencias. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Nelly Berenice González-Tovar
- Instituto Mexicano del Seguro Social, Centro Médico la Raza, Hospital de Especialidades, Servicio de Urgencias. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Jeon ES, Lim SW, Kim SY, Yang HM, Kim MH, Rhee MY, Han SH, Shin J, Kim KI, Jeong JO, Sung KC, Hong GR, Kim HS, Kwon K, Kang TS, Lee HY, Han SE. A randomized, double-blind, multicenter, phase III study on the efficacy and safety of a combination treatment involving fimasartan, amlodipine, rosuvastatin in patients with essential hypertension and dyslipidemia who fail to respond adequately to fimasartan monotherapy. Clin Hypertens 2022; 28:40. [DOI: 10.1186/s40885-022-00223-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/31/2022] [Indexed: 12/02/2022] Open
Abstract
Abstract
Background
To assess the efficacy and safety of a combination therapy involving fimasartan, amlodipine, and rosuvastatin in patients with essential hypertension and dyslipidemia who fail to respond to fimasartan monotherapy.
Methods
This phase III, randomized, double-blind, multicenter study was conducted in adults aged 19–70 years. Patients who voluntarily consented were screened for eligibility to enroll in the study. Patients who failed to respond to 4 weeks of fimasartan monotherapy were randomized with a 1:1:1 ratio to the fimasartan 60 mg/amlodipine 10 mg + rosuvastatin 20 mg (FMS/ALD + RSV) as study group, fimasartan 60 mg/amlodipine 10 mg (FMS/ALD) as control 1 group, and fimasartan 60 mg + rosuvastatin 20 mg (FMS + RSV) as control 2 group. The primary efficacy endpoints were the change in the sitting systolic blood pressure and the rate of change in the low-density lipoprotein cholesterol (LDL-C) level from baseline to 8 weeks. The adverse events, adverse drug reactions, physical examination findings, laboratory test results, electrocardiograms, and vital signs were evaluated to assess safety in the study.
Results
Of 138 randomized patients, 131 were conducted efficacy analysis, and 125 completed the study. For the change in LDL-C and sitting SBP (SiSBP) as primary efficacy assessments, the change in LDL-C at week 8 was significantly reduce in the FMS/ALD + RSV group than in the control 1 group (P < 0.001). The change in SiSBP at week 8 were greater reduce in the FMS/ALD + RSV group than in the FMS + RSV group (both P < 0.001). For the safety evaluation, there were no differences among the treatment groups in the incidence of adverse drug reactions.
Conclusions
The fimasartan/amlodipine + rosuvastatin combination therapy can effectively and safely lower blood pressure and improve lipid levels in patients with essential hypertension and dyslipidemia who fail to respond adequately to fimasartan monotherapy.
Trial registration
NCT03156842, Registered 17 May 2017
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Lee S, Yang S, Chang MJ. Antihypertensive effects of rosuvastatin in patients with hypertension and dyslipidemia: A systemic review and meta-analysis of randomized studies. PLoS One 2021; 16:e0260391. [PMID: 34818350 PMCID: PMC8612562 DOI: 10.1371/journal.pone.0260391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Some studies have suggested the antihypertensive effects of statins, a class of lipid-lowering agents, particularly in patients with hypertension. However, the evidence for the role of statins in blood pressure (BP) lowering is controversial, and no meta-analysis of rosuvastatin therapy has been conducted to assess its BP-lowering effects. Therefore, the aim of this meta-analysis of randomized controlled trials (RCTs) was to investigate the effects of rosuvastatin on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with hypertension. We systematically searched the electronic databases MEDLINE, EMBASE, and Cochrane Library to identify RCTs in which patients were assigned to groups of rosuvastatin plus antihypertensive agents vs. antihypertensive agents. The three authors independently selected the studies, extracted data, and assessed methodological quality. We included five RCTs in this meta-analysis with 288 patients treated with rosuvastatin and 219 patients without rosuvastatin. The mean DBP in the rosuvastatin group was significantly lower than that in the non-rosuvastatin group by -2.12 mmHg (95% confidence interval (CI) -3.72 to -0.52; Pfixed-effects model = 0.009; I2 = 0%, Pheterogeneity = 0.97). Rosuvastatin treatment also lowered the mean SBP compared with the non-rosuvastatin treatment by -2.27 mmHg, but not significantly (95% CI - 4.75 to 0.25; Pfixed-effects model = 0.08; I2 = 0%, Pheterogeneity = 0.82). In this study, we reviewed the antihypertensive effects of rosuvastatin in patients with hypertension and dyslipidemia. We demonstrated a modest significant reduction of DBP and a trend toward a lowered SBP in patients with hypertension with rosuvastatin therapy. Rosuvastatin could be beneficial to control hypertension and, consequently, contribute toward reducing the risk of cardiovascular events in patients with hypertension and dyslipidemia.
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Affiliation(s)
- Sungjae Lee
- Department of Pharmaceutical Medicine and Regulatory Sciences, Colleges of Medicine and Pharmacy, Yonsei University, Incheon, Republic of Korea
| | - Seungwon Yang
- Department of Pharmacy and Yonsei Institute of Pharmaceutical Science, College of Pharmacy, Yonsei University, Incheon, Republic of Korea
| | - Min Jung Chang
- Department of Pharmaceutical Medicine and Regulatory Sciences, Colleges of Medicine and Pharmacy, Yonsei University, Incheon, Republic of Korea
- Department of Pharmacy and Yonsei Institute of Pharmaceutical Science, College of Pharmacy, Yonsei University, Incheon, Republic of Korea
- Department of Industrial Pharmaceutical Science, Yonsei University, Incheon, Republic of Korea
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Comparative efficacy of fixed-dose statin and antihypertensive agent combinations: A network meta-analysis of randomized controlled trials. Vascul Pharmacol 2021; 141:106900. [PMID: 34343694 DOI: 10.1016/j.vph.2021.106900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND The concurrent administration of statins and antihypertensive agents has been associated with improved cardiovascular outcomes, although the optimal fixed-dose combination remains unclear. This meta-analysis aims to compare the blood pressure and lipid-lowering effects of various statin and antihypertensive drug combinations. METHODS PubMed, Scopus, Web of Science, CENTRAL and Clinicaltrials.gov were systematically searched from inception to 20 March 2021. Randomized controlled trials evaluating the effects of statin-antihypertensive agent combinations on systolic blood pressure or serum lipids were held eligible. A random-effects frequentist model was applied to provide estimates of mean difference of percentage change. RESULTS Overall, 18 studies were included, comprising 4450 patients. Compared to statin monotherapy no significant difference in the percentage change of low-density lipoprotein cholesterol was achieved by adding any antihypertensive agent. Compared to amlodipine monotherapy, the addition of moderate-intensity statin resulted in a significantly greater percentage reduction of systolic blood pressure (-2.22%, 95% confidence intervals: [-3.82 to -0.62]). Combined high-intensity statin and amlodipine lead to significant increase of high-density lipoprotein cholesterol (8.34%, 95% confidence intervals: [0.73 to 15.95]), while effective triglyceride reduction was achieved by adding amlodipine and telmisartan to high-intensity statin (-14.68%, 95% confidence intervals: [-28.48 to -0.89]). No significant difference of adverse effects was observed. CONCLUSION The present network meta-analysis suggests that the administration of fixed-dose combinations of statins and antihypertensive agents is safe and effective in reducing blood pressure and serum lipids. The optimal dosing strategy to prevent cardiovascular events remains to be determined.
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Kim H, Lee CJ, Choi D, Kim BK, Kim IC, Kim JS, Ahn CM, Hong GR, Cho IJ, Shim CY, Lee SH. Lipid-Lowering Efficacy and Safety of a New Generic Rosuvastatin in Koreans: an 8-Week Randomized Comparative Study with a Proprietary Rosuvastatin. J Lipid Atheroscler 2020; 9:283-290. [PMID: 32821737 PMCID: PMC7379087 DOI: 10.12997/jla.2020.9.2.283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/17/2020] [Accepted: 03/03/2020] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of this study was to investigate whether a new generic rosuvastatin is non-inferior to a proprietary one in terms of lipid-lowering efficacy. We also evaluated its non-lipid effects including adverse events. Methods One-hundred and fifty-eight patients with cardiovascular risks requiring pharmacological lipid-lowering therapy were screened. After a 4-week run-in period, 126 individuals who met the lipid criteria for drug therapy were randomly assigned to receive the new generic or proprietary rosuvastatin 10 mg daily for 8 weeks. The primary outcome variables were low-density lipoprotein-cholesterol (LDL-C) reduction and LDL-C target achievement. Hematological and biochemical parameters and adverse events were assessed. Results After 8 weeks of drug treatment, the mean percentage change in LDL-C was not different between the groups (−45.5%±19.9% and −45.1%±19.0% for generic and proprietary rosuvastatin, respectively; p=0.38). The LDL-C target achievement rate was similar between the groups (75.0% and 77.1% for generic and proprietary rosuvastatin, respectively; p=0.79). The percentage change in the other lipid profiles was not significantly different. Although generic- and proprietary rosuvastatins modestly affected creatine kinase and blood pressure, respectively, the changes were all within normal ranges. Incidence of adverse events did not differ between the receivers of the 2 formulations. Conclusion The new generic rosuvastatin was non-inferior to the proprietary rosuvastatin in terms of lipid-lowering efficacy. The rosuvastatin formulations did not exhibit clinically significant non-lipid effects with good safety profiles. Our study provides comprehensive data regarding 2 rosuvastatin formulations in East Asian subjects. Trial Registration ClinicalTrials.gov Identifier: NCT03949374
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Affiliation(s)
- Hyoeun Kim
- Department of Health Promotion, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Joo Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Byeong-Keuk Kim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - In-Cheol Kim
- Division of Cardiology, Department of Internal Medicine, Dongsan Medical Center, Keimyung University College of Medicine, Daegu, Korea
| | - Jung-Sun Kim
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Chul-Min Ahn
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Geu-Ru Hong
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - In-Jeong Cho
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea
| | - Chi-Young Shim
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Hak Lee
- Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Lee SJ, Oh J, Hong SJ, Cho IJ, Kim SR, Uhm JS, Shim CY, Chang HJ, Ahn CM, Kim JS, Kim BK, Park S, Lee SH, Hong GR, Ko YG, Choi D. Effectiveness of Fimasartan and Rosuvastatin Combination Treatment in Hypertensive Patients With Dyslipidemia. Clin Ther 2020; 42:1058-1066.e3. [PMID: 32376036 DOI: 10.1016/j.clinthera.2020.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/25/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE The goal of this study was to evaluate the concurrent control rate of hypertension and dyslipidemia by fimasartan and rosuvastatin in patients who were concomitantly prescribed both drugs. METHODS This single-center, cross-sectional study was conducted in 536 patients with hypertension and dyslipidemia who were taking fimasartan and rosuvastatin together for at least 12 weeks. Patients were enrolled from October 2016 to March 2018 at a tertiary hospital in the Republic of Korea. The primary end point was the concurrent control rate of blood pressure (<140/90 mm Hg) and LDL-C. As a secondary end point, the target blood pressure <130/80 mm Hg was adopted in all patients or in high-risk patients with atherosclerotic cardiovascular diseases. Target LDL-C and non-HDL-C levels followed the domestic guidelines. Correlation between blood pressure control and lipid profile was also evaluated. All parameters were assessed in a clinic by board-certified physicians. FINDINGS Of the total 536 patients, 69% (n = 368) had very high (n = 308) or high (n = 60) cardiovascular risk, with an average age of 65 years; 57% were male. When the target blood pressure was set at 140/90 mm Hg, the proportion of patients meeting the targeting LDL-C level was 40.3% (95% CI, 36.2-44.5; P < 0.001). When applied to the revised blood pressure criteria targeting 130/80 mm Hg, the concurrent control rate dropped by one half to 20.3% (95% CI, 17.2-24.0; P < 0.001). To apply the new blood pressure criteria, more intensive management is mandatory in patients with high or very high cardiovascular risk. There was no positive correlation between the controlled rate of hypertension and dyslipidemia. IMPLICATIONS Fimasartan and rosuvastatin were shown to have effects on target diseases, but there was no synergistic effect when administered in combination. The higher the cardiovascular risk of the patients, the lower the rate of concurrent control when fimasartan and rosuvastatin were administered simultaneously. More active treatment is therefore required in high-risk patients.
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Affiliation(s)
- Seung-Jun Lee
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Jaewon Oh
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Sung-Jin Hong
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - In-Jeong Cho
- Cardiology Division, Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Republic of Korea
| | - Su Rae Kim
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Sun Uhm
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Chi Young Shim
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Hyuk-Jae Chang
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Chul-Min Ahn
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Jung-Sun Kim
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Byeong-Keuk Kim
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Sungha Park
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Sang-Hak Lee
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Geu Ru Hong
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Young-Guk Ko
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea
| | - Donghoon Choi
- Cardiology Division, Department of Internal Medicine, Severance Cardiovascular Hospital, Seoul, Republic of Korea.
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Does Co-administration of Antihypertensive Drugs and Statins Alter Their Efficacy and Safety? A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Cardiovasc Pharmacol 2019; 73:352-358. [DOI: 10.1097/fjc.0000000000000671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Purpose of Review The purpose of this review is to summarize the most recent data available on advances in development of novel medical treatments for hypertension and related comorbidities. Recent Findings Approximately half of all hypertensive patients have not achieved goal blood pressure with current available antihypertensive medications. Recent landmark studies and new hypertension guidelines have called for stricter blood pressure control, creating a need for better strategies for lowering blood pressure. This has led to a shift in focus, in recent years, to the development of combination pills as a means of achieving improved blood pressure control by increasing adherence to prescribed medications along with further research and development of promising novel drugs based on discovery of new molecular targets such as the counter-regulatory renin-angiotensin system. Summary Fixed-dose combination pills and novel treatments based on recently discovered pathogenic mechanisms of hypertension that have demonstrated promising results as treatments for hypertension and related comorbidities will be discussed in this review.
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Affiliation(s)
- Jared Davis
- Department of Medicine, University of Alabama at Birmingham, BDB 327, 1720 2nd Ave S, Birmingham, AL, 35294, USA.
| | - Suzanne Oparil
- UAB Vascular Biology and Hypertension Program, Division of Cardiovascular Disease, University of Alabama at Birmingham, ZRB 1034, 703 19th St S, Birmingham, AL, 35233, USA
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Angeli F, Verdecchia P, Trapasso M, Pane M, Signorotti S, Reboldi G. PK/PD evaluation of fimasartan for the treatment of hypertension Current evidences and future perspectives. Expert Opin Drug Metab Toxicol 2018; 14:533-541. [PMID: 29676941 DOI: 10.1080/17425255.2018.1468435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Fimasartan is the ninth and latest Angiotensin Receptor Blockers for the treatment of hypertension. Fimasartan is a derivative of losartan in which the imidazole ring has been replaced. It provides a selective type 1 angiotensin II receptor antagonist effect with noncompetitive, in surmountable binding. Fimasartan is rapidly absorbed following oral administration with an oral bioavailability of 18.6 ± 7.2%. Fimasartan is relatively stable in terms of metabolism and more than 90% of circulating fimasartan moieties in the plasma are in the parent form; fecal elimination and biliary excretion are the predominant elimination pathways of fimasartan. Areas covered: We reviewed data from clinical trials that investigated safety and efficacy of fimasartan in hypertension. Expert opinion: Fimasartan proved good efficacy in blood pressure reduction. In large clinical studies,fimasartan showed an excellent safety profile and when combined with hydrochlorothiazide oram lodipine, it showed a better effect on controlling blood pressure than monotherapy. Fimasartan 60-120 mg once daily has also shown an antihypertensive effect over 24-h. Moreover, preclinical studies demonstrated organ-protecting effects of fimasartan. These results make fimasartan an attractive candidate for the treatment of hypertension. However, it remains to test the benefit of using fimasartan on clinical outcomes.
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Affiliation(s)
- Fabio Angeli
- a Department of Cardiology and Cardiovascular Pathophysiology , Hospital and University of Perugia , Perugia , Italy
| | - Paolo Verdecchia
- b Department of Internal Medicine , Hospital of Assisi , Assisi , Italy
| | - Monica Trapasso
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Marina Pane
- c Department of Medicine , University of Perugia , Perugia , Italy
| | - Sara Signorotti
- c Department of Medicine , University of Perugia , Perugia , Italy
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Lee J, Rhee SJ, Lee S, Yu KS. Evaluation of drug interactions between fimasartan and rosuvastatin after single and multiple doses in healthy Caucasians. DRUG DESIGN DEVELOPMENT AND THERAPY 2018; 12:787-794. [PMID: 29670335 PMCID: PMC5896677 DOI: 10.2147/dddt.s145339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Objectives As hypercholesterolemia is often accompanied by hypertension, statins are usually prescribed with angiotensin receptor blockers in clinical practice. This study was performed to evaluate the pharmacokinetics and safety of fimasartan and rosuvastatin when coadministered or administered alone as a single dose or as multiple doses to healthy Caucasians. Methods Thirty-six subjects were enrolled into an open-labeled, randomized, 6-sequence, 3-period, 3-way crossover study, and randomly received fimasartan (120 mg), rosuvastatin (20 mg) or both. Blood samples for pharmacokinetics were collected up to 48 hours for fimasartan and 72 hours for rosuvastatin after the last dosing and plasma concentrations of study drugs were determined by liquid chromatography-tandem mass spectrometry. Maximum plasma concentration (Cmax), area under the concentration-time curve (AUC) from 0 to the last measurable time (AUClast), maximum plasma concentration at steady state (Cmax,ss) and AUC to the end of the dosing period at steady state (AUCτ,ss) were estimated using a non-compartmental method. Safety and tolerability were evaluated throughout the study. Results Thirty subjects completed the study. After single dose administration, the geometric mean ratio (GMR) and 90% confidence intervals (CIs) of fimasartan with or without rosuvastatin were 0.95 (0.80–1.14) and 0.98 (0.91–1.07) for Cmax and AUClast, respectively. The corresponding values for rosuvastatin with or without fimasartan were 1.32 (1.16–1.50) and 0.97 (0.89–1.05), respectively. After administration of multiple doses, the GMRs (90% CIs) for Cmax,ss and AUCτ,ss of fimasartan with or without rosuvastatin were 0.94 (0.74–1.20) and 1.07 (0.90–1.16), respectively. The corresponding values for rosuvastatin with or without fimasartan were 1.16 (1.02–1.32) and 0.86 (0.79–0.94), respectively. A total of 74 adverse events (AEs) were reported and incidences of AEs did not increase significantly with co-administration. Conclusion Co-administration of fimasartan and rosuvastatin did not result in clinically relevant changes in the systemic exposure of fimasartan or rosuvastatin after single and multiple administrations, and they were well tolerated.
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Affiliation(s)
- Jieon Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su-Jin Rhee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - SeungHwan Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Sang Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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