This article is more than 5 years old. Information may no longer be current.

ONTARGET: ARB as effective as ACE-inhibitor, no need for combination

Issue: May 2008

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

CHICAGO – Telmisartan has fewer side effects than rampiril in patients with vascular disease or diabetes, but the efficacy of the two are similar, according to data presented at the American College of Cardiology’s Scientific Sessions.

Salim Yusuf, MD, director of the Population Health Research Institute at McMaster University in Ontario, presented the results from the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET). The researchers aimed to determine the efficacy of rampiril (Altace, King Pharmaceuticals), telmisartan (Micardis, Boehringer Ingelheim) or the two in combination in patients older than 55 years old with vascular disease or diabetes.

Patients were randomly assigned 10 mg of ramipril per day (n=8576), 80 mg of telmisartan per day (n=8,542) or both (n=8,502).

In both the telmisartan and combination cohorts, mean BP was lower than in the rampiril group (0.9/0.6 mm Hg and 2.4/1.4 mm Hg greater reductions). The primary outcome (death from cardiovascular causes, MI, stroke, or hospitalization for HF) occurred in 1,412 patients in the rampiril cohort (16.5%), compared with 1,423 in the telmisartan cohort (relative risk, 1.01; 95% CI, 0.94-1.09) and 1,386 in the combination cohort (RR, 0.99; 95% CI, 0.92-1.07) after a median follow up of 56 months, according to Yusuf.

Cough and angioedema rates were lower in the telmisartan group, compared with rampiril (1.1% vs. 4.2%, P<0.001 and 0.1% vs. 0.3%, P=0.01), though hypotensive symptoms were higher (2.6% vs. 1.7%, P<0.001). Overall, the combination of rampiril and telmisartan resulted in additional adverse events and fewer benefits in patients with vascular disease or diabetes.

Results of the trial were published in an online-first edition of the New England Journal of Medicine. - by Stacey Adams

For more information:

• Yusuf S. Results of the ONTARGET study comparing ramipril with telmisartan, and its combination in high-risk individuals without heart failure. ACC LBCT I. Presented at: American College of Cardiology’s 57th Annual Scientific Session; March 29-April 1, 2008. Chicago.
• Yusuf S, Teo KK, Anderson C, et al.. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 10.1056/NEJMoa0801317