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New Study Shows That telmisartan has Greater Renoprotective,Potential Thanlosartan in Hypertensive Patients With Type 2,Diabetes



AMADEO, a randomized, double-blind, forced-titration, parallel-group, multicentre study, included 860 hypertensive patients ((greater than)130/80mmHg) with type 2 diabetes and overt nephropathy from 124 centres in 10 countries. Patients were randomized to receive treatment with either telmisartan 80mg or losartan 100mg. To ensure blood pressure control in the two patient groups other non- ARB treatments (hydrochlorothiazide or calcium channel blocker) were added, if needed.

After one year's treatment, telmisartan was significantly more effective than losartan in reducing the amount of protein excreted in the urine. The primary end point of the study was reduced by 29% with telmisartan vs. 20% with losartan; p=0.0284(1). Telmisartan was superior to losartan on the primary endpoint, a change from baseline after 12 months (log transformed Urinary Protein creatinine ratio) of 0.71 (95% CI; 0.66, 0.77) vs. 0.80 (95% CI; 0.74,0.87) for losartan; p=0.0284.(1) No significant difference in blood pressure control or number of adverse events was observed between the two treatments groups(1). Proteinuria (high levels of protein in the urine) is a very important signal for disease severity in diabetic nephropathy and is also considered a relevant cardiovascular risk factor. Renal outcomes trials have shown that reductions of (greater than)30% at six months are strongly linked to slowed progression to end-stage kidney disease and reduced cardiovascular events.(6)

AMADEO successfully concludes the series of PROTECTION studies which are part of an extensive ongoing trial programme, including clinical and observational studies, investigating the outstanding effects of telmisartan compared with other treatments for hypertension, including other available ARBs. The trials established the effects of telmisartan in providing powerful blood pressure reductions from morning to morning as well as organ-protective
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