The Comparative Study of Azilsartan with Telmisartan in Terms of Efficacy, Safety and Cost - Effectiveness in Hypertension
Introduction: Hypertension (HT) represents the most common cardiovascular risk factor amongst the cluster group of Cardiovascular Diseases (CVD). Clinically, HT might be defined as that level of Blood Pressure (BP) at which the institution of therapy reduces the BP-related morbidity and mortality. Azilsartan (AZL) is a relatively new Angiotensin Receptor Blocker (ARB) available for the treatment of any stage of HT. Aim: To compare the efficacy, safety and cost-effectiveness of AZL 40-80 mg once daily versus telmisartan 40-80 mg once daily in patients of stage-I HT. Methods: A prospective, open, randomized parallel group comparative study of AZL versus telmisartan was done in patients of stage-I HT. The study included 80 patients, 40 in each group (group I and group II) coming to the department of Medicine, Rajindra Hospital attached to Government Medical College, Patiala. The study was conducted over 8 weeks. Group I, patients received Azilsartan 40-80 mg per day in divided doses and group II, patients received telmisartan 40-80 mg per day in divided doses according to severity of hypertension. The therapeutic efficacy of drugs was evaluated by monitoring BP. Adverse drug reactions were monitored in patients. The daily cost for each medication was noted and total cost of drugs taken over 8 weeks was calculated. Effectiveness of the drugs was calculated in terms of mm Hg fall in mean BP. All the observations thus made were statistically analyzed using appropriate tests. Results: Patients receiving AZL 40mg and telmisartan 40mg showed a significant fall (p<0.05) in systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) at 4 weeks and 8 weeks, when compared to baseline. The difference in SBP and DBP between Group I (AZL) and II (Telmisartan) was statistically significant at 4 weeks (p<0.05) and was highly significant at 8 weeks (p<0.001). Adverse effects such as nasopharyngitis, upper respiratory tract infection, gastroenteritis, headache, dizziness, and fatigue were reported with both drugs. Conclusions: Reduction of BP with AZL was more as compared to telmisartan at 4 weeks and 8 weeks. Safety and tolerability was similar in both groups.
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How to Cite
Bhajni, E., Sehgal, V. K., Kumar, A., & Sehgal, A. (2020). The Comparative Study of Azilsartan with Telmisartan in Terms of Efficacy, Safety and Cost - Effectiveness in Hypertension. International Journal of Medical and Dental Sciences, 9(1), 1811–1817. https://doi.org/10.18311/ijmds/2020/24723
- Michel T, Hoffman BB. Therapy of Myocardial Ischemia and Hypertension. In: Brunton L, Chabner B & Knollman B, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics.12th ed. USA: McGraw Hills; 2011. p. 746-88.
- Kotchen TA. Hypertensive vascular disease. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison’s Principles of Internal Medicine. 17th ed. New York: McGraw Hills; 2008. p. 1553-67.
- Ismail J, Jafar TH, Jafary FH, White F, Faruqui AM, Chaturvedi N. Risk factors for non-fatal myocardial infarction in young South Asian adults. Heart. 2004 Mar; 90(3):259-63. https://doi.org/10.1136/hrt.2003.013631. PMid: 14966040, PMCid: PMC1768096.
- Park K. Park’s Textbook of preventive and social medicine. 24th Ed. India: Banarsidas Bhanot; 2017. p. 392.
- Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005 Jan; 365:217-23.
- Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Angelantonio ED, et al. Hypertension in India: A systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J. Hypertens. 2014 Jun; 32(6):117077. https://doi.org/10.1097/HJH.0000000000000146. PMid: 24621804, PMCid: PMC4011565.
- Stafylas PC, Sarafidis PA. Carvedilol in hypertension treatment. Vasc Health Risk Manag. 2008 Feb; 4(1):2330. https://doi.org/10.2147/vhrm.2008.04.01.23. PMid: 18629377, PMCid: PMC2464772.
- Neal B, MacMahon S, Chapman N. Effects of ACE inhibitors, calcium antagonists, and other blood-pressurelowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet. 2000; 356:1955-64.
- Arauz-Pacheco C, Parrot MA, Raskin P. Treatment of hypertension in adults with diabetes. Diabetes Care. 2003 Jan; 26 (1):80-82. https://doi.org/10.2337/diacare.26.2007.S80.
- Kumar PR AJ, Priya K, Srivastava P, Paul D. To compare the pleiotropic effects of telmisartan and olmesartan in hypertensive patients with metabolic syndrome based on ATP III criteria. Isor Journal of Pharmacy. 2013; 3(1)59-67. https://doi.org/10.9790/3013-31305966.
- Shah MUD. Azilsartan: New angiotensin receptor blocker for hypertension. Physicians Academy. 2017; 11(4):30-2.
- Dandan RH. Renin and Angiotensin. In: Brunton LL, Dandan RH, Knollman, BC, editors. Goodman and Gilman’s the Pharmacological Basis of Therapeutics. 13th ed. USA: McGraw-Hill; 2018. p. 471-88.
- McGhgan WF. Pharmacoeconomics. In: Arnold RJG, editor. Pharmacoeconomics from Theory to Practice. Boca Raton: CRC Press; 2010. p. 4.
- Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007; 370:1929-38.
- Kohara Y, Imamiya E, Kubo K, Wada T, Inada Y, Naka T. A new class of angiotensin II receptor antagonists with a novel acidic bioisostere. Bioorganic Medicinal Chemistry Letters. 1995; 5(17):1903-08. https://doi.org/10.1016/0960894X(95)00319-O.
- Kohara Y, Kubo K, Imamiya E, Wada T, Inada Y, Naka T. Synthesis and angiotensin II receptor antagonistic activities of benzimidazole derivatives bearing acidic heterocycles as novel tetrazole bioisosteres. J. Med. Chem. 1996; 39(26):5228-35. https://doi.org/10.1021/jm960547h.
- White WB, Weber MA, Sica D. Effects of the angiotensin receptor blocker azilsartan medoxomil versus olmesartan and valsartan on ambulatory and clinic blood pressure in patients with stages 1 and 2 hypertension. J. Am. Heart Assoc. 2011; 57(3):413-20. https://doi.org/10.1161/HYPERTENSIONAHA.110.163402.
- Barkis GL, Sica D, Weber M, White WB, Roberts A, Perez A, et al. The comparative effects of azilsartan medoxomil and olmesartan on ambulatory and clinic blood pressure. J. Clin. Hypertens. 2011; 13(2):81-88. https://doi.org/10.1111/ j.1751-7176.2010.00425.x.