Inpharma 1637 - 10 May 2008

Amlodipine/valsartan combosuperior to amlodipine/atenolol

Amlodipine/valsartan combination therapy is moreeffective than amlodipine/atenolol in preventingrecurrences of atrial fibrillation (AF) in hypertensivepatients with type 2 diabetes mellitus and a recenthistory of AF, conclude researchers from an Italianstudy.

The open label, blind-endpoint evaluation studyinvolved 296 such patients randomly assigned to receiveamlodipine 2.5 mg/day and either valsartan 160 mg/day(n = 148) or atenolol 100 mg/day. Amlodipine wastitrated up to 10 mg/day in nonresponders. Previousantiarrhythmic drugs were continued for the duration ofthe trial, however, antihypertensive use ceased during a2-week washout period prior to trial commencement.Both treatments were found to significantly reduce BPfrom baseline (p < 0.001) with amlodipine/valsartandecreasing systolic BP by 24.1mm Hg and diastolic BPby 16.1mm Hg, and amlodipine/atenolol by 24.0mm Hgand 16.3mm Hg, respectively. No significant differencewas observed between treatments. By week 16,8 patients (5.4%) in the amlodipine/valsartan group hadexperienced a recurrence of AF, compared with18 (12.2%) in the amlodipine/atenolol group. After 1year this had increased to 28 and 47 patients,respectively; the difference was significant (p < 0.01).Interestingly, post-hoc analysis of antiarrhythmicsubgroups revealed the benefit of amlodipine/valsartanto be enhanced in patients concomitantly receivingamiodarone or propafenone and diminished in thosereceiving disopyramide or flecainide.

See also Inpharma 1629 p6; 801104762Fogari R, et al. Comparative evaluation of effect of valsartan/amlodipine andatenolol/amlodipine combinations on atrial fibrillation recurrence in hypertensivepatients with type 2 diabetes mellitus. Journal of Cardiovascular Pharmacology 51:217-222, No. 3, Mar 2008 801080758

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Inpharma 10 May 2008 No. 16371173-8324/10/1637-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved