AMADEO

18 Aug, 10

AMADEO

Telmisartan is superior to losartan reducing proteinuria in hypertensives with diabetic nephropathy-Results of the AMADEO trial.

Aim

To compare the efficacy of telmisartan with losartan in reducing proteinuria in hypertensives with diabetic nephropathy

Study Patients

Hypertensives (blood pressure > 130/80 mm Hg) with type 2 diabetes and overt nephropathy (morning spot urinary protein to creatinine (UPC) ratio of > 700 mg/g) [N=860]

Study Groups

Telmisartan initiated at 40 mg/day for 2 weeks followed by 80 mg/day [n=419]
Losartan initiated at 50 mg/day for 2 weeks followed by 100 mg/day [n=441]

Study Duration

52 weeks

Primary Endpoint

Change from baseline in early-morning spot UPC

Results

Significantly greater reduction in UPC was observed with telmisartan compared to losartan (Fig. 1)

Figure 1: Changes in UPC in each group

Significantly greater reduction in urinary albumin: creatinine was seen in telmisartan recipients (35.5%) as compared to losartan (27%)
Incidence of composite of cardiovascular morbidity or mortality and all-cause mortality was significantly lower with telmisartan vs. losartan (Fig. 2)

Figure 2: Incidence of cardiovascular morbidity/mortality & all-cause mortality

Conclusion

Telmisartan shows a greater antiproteinuric effect in hypertensives with diabetic nephropathy compared to losartan.

Kidney Int 2008;74:364-9