The FimAsartaN proTeinuriA SusTaIned reduCtion in comparison with losartan in diabetic chronic kidney disease (FANTASTIC) trial.

Autor: Yoo TH; Division of Nephrology, Severance Hospital, Seoul, Korea., Hong SJ; Department of Cardiology, Korea University Anam Hospital, Seoul, Korea., Kim S; Division of Nephrology, Hallym University Sacred Heart Hospital, Ansan, Korea., Shin S; Division of Nephrology, Incheon St. Mary's Hospital, The Catholic University, Incheon, Korea., Kim DK; Division of Nephrology, Seoul National University Hospital, Seoul, Korea., Lee JP; Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea., Han SY; Division of Nephrology, Inje University Ilsan-Paik Hospital, Goyang, Korea., Lee S; Department of Nephrology, College of Medicine, Kyung Hee University, Seoul, Korea., Won JC; Division of Endocrinology and Metabolism, Inje University Sanggye-Paik Hospital, Inje University School of Medicine, Seoul, Korea., Kang YS; Division of Nephrology, Korea University Ansan Hospital, Ansan, Korea., Park J; Division of Nephrology, Ulsan University Hospital, Ulsan, Korea., Han BG; Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Korea., Na KR; Division of Nephrology, Chungnam National University Hospital, Daejeon, Korea., Hur KY; Division of Endocrinology and Metabolism, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea., Kim YJ; Division of Cardiology, Seoul National University Hospital, Seoul, Korea., Park S; Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea. shpark0530@yuhs.ac.
Jazyk: angličtina
Zdroj: Hypertension research : official journal of the Japanese Society of Hypertension [Hypertens Res] 2022 Dec; Vol. 45 (12), pp. 2008-2017. Date of Electronic Publication: 2022 Sep 20.
DOI: 10.1038/s41440-022-01028-6
Abstrakt: As angiotensin II type 1 receptor blockers (ARBs) may have different antiproteinuric effects in diabetic kidney disease (DKD), we ascertained the albuminuria-reducing effect of fimasartan and losartan in patients with DKD. This was a randomized, multicenter, double-blind, 4-parallel-group, dose-titration, phase III study designed to compare the efficacy of fimasartan and losartan in reducing albuminuria in patients with DKD (NCT02620306). The primary endpoint was the rate of change in albuminuria from baseline to week 24. A total of 341 patients were randomized to different groups. The urinary albumin-to-creatinine ratio (ACR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were not different between the fimasartan and losartan groups at baseline (ACR: 1376.84 vs. 1521.07 mg/gCr, SBP: 154.69 vs. 154.47 mmHg, DBP: 83.96 vs. 83.83 mmHg). However, ACR reduction was significantly larger in the fimasartan group than in the losartan group during the entire study period (% changes in the ACR at 4, 8, 12, and 24 weeks were -23.58, -33.06, -35.00, and -38.13 in the fimasartan group vs. -8.74, -10.17, -14.91, and -19.71 in the losartan group, p < 0.01, respectively). The superior antiproteinuric effect of fimasartan compared to losartan was still significant after adjustment for SBP levels. There were no significant differences in adverse events, including the incidences of estimated glomerular filtration decline and hyperkalemia. This study demonstrates that compared to losartan, fimasartan significantly reduces albuminuria in patients with DKD, even after adjustment for SBP and DBP.
(© 2022. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)
Databáze: MEDLINE
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