Nakajima Tadashi, Oh Akinori, Saita Shun, Yoshida Takuo, Ohishi Mitsuru, Nishigaki Nobuhiro
Japan Medical Office, Takeda Pharmaceutical Company Limited Tokyo Japan.
Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University Kagoshima Japan.
Circ Rep. 2020 Sep 18;2(10):576-586. doi: 10.1253/circrep.CR-20-0076.
Angiotensin II receptor blockers (ARBs) are widely used for the management of hypertension in Japan; however, comparative efficacy data within the ARB drug class remain limited. This systematic literature review identified randomized controlled trials (RCT) indexed in PubMed and Ichushi in Japanese patients with hypertension receiving ARB monotherapy (azilsartan, candesartan cilexetil, irbesartan, losartan potassium, olmesartan medoxomil, telmisartan, valsartan) in at least 1 arm. Of 763 RCTs identified, 77 met the eligibility criteria; of which, 37 reported mean change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) from baseline in the office setting and were used to construct the network. A fixed-effects model (FEM) showed the effect of each drug vs. the reference, azilsartan. Using the FEM, the mean (95% credible interval) change from baseline in SBP/DBP for candesartan cilexetil, irbesartan, losartan potassium, olmesartan medoxomil, telmisartan, and valsartan was 3.8 (2.9-4.8)/2.6 (2.0-3.1), 4.8 (2.0-7.5)/3.7 (1.8-5.6), 3.0 (0.8-5.1)/1.9 (0.5-3.3), 3.2 (1.2-5.1)/2.7 (1.3-4.1), 3.2 (0.8-5.6)/2.0 (0.3-3.6), and 3.1 (1.1-5.1)/2.4 (1.1-3.8) mmHg, respectively. The results of this meta-analysis provide evidence that azilsartan has a more favorable efficacy profile than the other ARBs in reducing SBP and DBP.
在日本，血管紧张素II受体阻滞剂（ARBs）被广泛用于治疗高血压；然而，ARB药物类别内的比较疗效数据仍然有限。本系统文献综述检索了在PubMed和日文版《医学中央杂志》（Ichushi）上索引的随机对照试验（RCT），这些试验涉及至少一组接受ARB单药治疗（阿齐沙坦、坎地沙坦酯、厄贝沙坦、氯沙坦钾、奥美沙坦酯、替米沙坦、缬沙坦）的日本高血压患者。在识别出的763项RCT中，77项符合纳入标准；其中，37项报告了诊室环境下收缩压（SBP）和舒张压（DBP）相对于基线的平均变化，并被用于构建网络。固定效应模型（FEM）显示了每种药物相对于对照药物阿齐沙坦的效果。使用FEM，坎地沙坦酯、厄贝沙坦、氯沙坦钾、奥美沙坦酯、替米沙坦和缬沙坦相对于基线的SBP/DBP平均变化（95%可信区间）分别为3.8（2.9 - 4.8）/2.6（2.0 - 3.1）、4.8（2.0 - 7.5）/3.7（1.8 - 5.6）、3.0（0.8 - 5.1）/1.9（0.5 - 3.3）、3.2（1.2 - 5.1）/2.7（1.3 - 4.1）、3.2（0.8 - 5.6）/2.0（0.3 - 3.6）和3.1（1.1 - 5.1）/2.4（1.1 - 3.8）mmHg。这项荟萃分析的结果提供了证据，表明在降低SBP和DBP方面，阿齐沙坦比其他ARB具有更有利的疗效。
