ONTARGET (Ongoing Telmisartan Alone and in Combination with Ramipril Global End-point Trial)

18 Mar, 14

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ONTARGET

TELMISARTAN as Effective as Ramipril in patients at High Risk for Vascular Events

Aim

To compare the ACE inhibitor ramipril, the ARB telmisartan, and the combination of the two drugs in patients with vascular disease or high-risk diabetes.

Study Patients

25,620 patients with coronary, peripheral, or cerebrovascular disease or diabetes with end-organ damage.

Telmisartan group = 8542 patients

Ramipril group = 8576 patients

Telmisartan + Ramipril group = 8502 patients

Study Groups

Telmisartan 80 mg
Ramipril 10 mg
Telmisartan 80 mg + Ramipril 10 mg

Study Duration

56 months

Results

Telmisartan (16.7%) was as effective as ramipril (16.5%) in reducing the primary composite outcome of death from cardiovascular causes, myocardial infarction, stroke,or hospitalization for heart failure (relative risk 1.01).

Telmisartan was as effective as ramipril in reducing the secondary endpoint of death from cardiovascular causes, myocardial infarction, or stroke.
Telmisartan had lower rates of cough (1.1%vs.4.2%) and angioedema (0.1%vs.0.3%) as compared to ramipril.
No additional advantage from the combination of telmisartan and ramipril used in full doses in this population, as compared with ramipril alone
Mean blood pressure was lower in both the telmisartan group (a 0.9/0.6 mm Hg greater reduction) and the combination-therapy group (a 2.4/1.4 mm Hg greater reduction) than in the ramipril group.

Conclusion

Telmisartan was equivalent to ramipril in patients with vascular disease or high-risk diabetes and was associated with less angioedema.

N Engl J Med 2008; 358: 1547-59

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