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Addition of Aliskiren to Irbesartan Improves Blood Pressure Control: Presented at AHA

By Jill Stein

DALLAS, TX -- November 15, 2005 -- Renin inhibition with aliskiren in combination with irbesartan appears to provide increased suppression of the renin-angiotensin-aldosterone system (RAAS), better 24-hour blood pressure control, and ultimately better end organ protection in patients with hypertension.

Researchers presented these findings here on November 13^th at the American Heart Association's Scientific Sessions 2005 (AHA).

Aliskiren is the first in a new class of orally effective renin inhibitors and has been shown to provide antihypertensive efficacy and tolerability comparable to the angiotensin receptor blocker losartan and irbesartan in patients with mild to moderate hypertension.

Eoin O'Brien, MD, Chairman, Clinical Pharmacology Division, Royal College of Surgeons, Dublin, Ireland, presented results from a study that tested the combination of aliskiren with irbesartan in 23 patients with grade 1 or 2 hypertension.

The researchers defined grade 1 or 2 hypertension as a systolic blood pressure between 140 mm Hg to 180 mm Hg. Subjects were 18 to 70 years of age.

The cohort underwent a 7- to 10-day washout of prior medications. Patients then received open-label irbesartan 150 mg once daily as monotherapy for 3 weeks, with the addition of aliskiren 75 mg for an additional 3 weeks, titrated to aliskiren 150 mg for another 3 weeks.

Irbesartan 150 mg significantly increased mean plasma renin activity from a baseline value of 0.74 ng/mL/h by 2.4 fold to 1.76 ng/mL/h (P < .001).

Aliskiren in combination with irbesartan inhibited the reactive rise in plasma renin activity (PRA) that normally results from angiotensin receptor blocker treatment. That is, the addition of aliskiren 75 mg titrated to 150 mg restored PRA to baseline values to 0.77 and 0.70 ng/mL/h, respectively (both P < .001 versus irbesartan monotherapy).

The addition of aliskiren 75 mg to irbesartan led to a significant decrease in mean daytime diastolic blood pressure, while both the 75 mg and 150 mg dose of aliskiren significantly enhanced the night-time diastolic blood pressure reductions following angiotensin receptor blocker monotherapy.

Aliskiren and irbesartan were well tolerated, Dr. O'Brien said.

The study was funded by Speedel Pharma AG.


[Presentation title: Aliskiren, An Orally Effective Renin Inhibitor, Suppresses Plasma Renin Activity and Improves Blood Pressure Lowering in Combination with Irbesartan in Patients with Hypertension. Abstract 2224]

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