MISC

2013年8月20日

Effects of telmisartan on proteinuria or albuminuria: A meta-analysis of randomized trials

International Journal of Cardiology
  • Hisato Takagi
  • ,
  • Hirotaka Yamamoto
  • ,
  • Kotaro Iwata
  • ,
  • Shin-Nosuke Goto
  • ,
  • Takuya Umemoto

167
4
開始ページ
1443
終了ページ
1449
記述言語
英語
掲載種別
DOI
10.1016/j.ijcard.2012.04.058

Background: Although telmisartan is suggested to improve proteinuria/albuminuria (or prevents progression of proteinuria/albuminuria), conclusive evidence is still lacking. We perform the first meta-analysis of randomized controlled trials of telmisartan therapy on proteinuria/albuminuria. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched through February 2012. Eligible studies were prospective randomized controlled trials of telmisartan therapy versus other angiotensin receptor blocker (ARB), angiotensin converting enzyme inhibitor (ACEI), other anti-hypertensive drug therapy, placebo, or no medication and reporting urinary protein/albumin excretion (UPE/UAE) or urinary protein/albumin to creatinine ratio (UPCR/UACR) levels as an outcome. For each study, data regarding percent changes from baseline to final UPE/UAE/UPCR/UACR levels in both the telmisartan and control groups were used to generate mean differences (MDs) and 95% confidence intervals (CIs). Results: Of 49 potentially relevant articles screened initially, 20 reports of randomized trials enrolling a total of 25,425 patients were included. Pooled analysis suggested a significant reduction in percent changes of UPE/UAE/UPCR/UACR in the 7 ARB-control (MD, - 19.99%
95% CI, - 28.68% to - 11.30%
p &lt
0.00001), 7 ACEI-control (MD, - 14.08%
95% CI, - 25.36% to - 2.80%
p = 0.01), 6 non-ARB/ACEI-control (MD, - 39.82%
95% CI, - 55.96% to - 23.69%
p &lt
0.00001), and all the 20 trials (MD, - 24.36%
95% CI, - 32.85% to - 15.87%
p &lt
0.00001). Conclusion: We found that, based on a meta-analysis of 20 randomized controlled trials including &gt
25,000 patients, telmisartan therapy is likely effective in the improvement of proteinuria/albuminuria or in the prevention of progression in proteinuria/albuminuria. © 2012 Elsevier Ireland Ltd.

リンク情報
DOI
https://doi.org/10.1016/j.ijcard.2012.04.058
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/22560941
URL
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=84881476573&origin=inward
ID情報
  • DOI : 10.1016/j.ijcard.2012.04.058
  • ISSN : 0167-5273
  • ISSN : 1874-1754
  • PubMed ID : 22560941
  • SCOPUS ID : 84881476573

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