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阿利沙坦酯/氨氯地平治疗原发性高血压患者的疗效与安全性:一项III期、多中心、双盲、平行组、随机研究。

Efficacy and Safety of Allisartan Isoproxil/Amlodipine in Patients with Essential Hypertension: A Phase III, Multicenter, Double-Blind, Parallel-Group, Randomised study.

作者信息

Chi Hongjie, Zhang Xin, Ma Shumei, Pan Gang, Lian Xiaojuan, Chen Yuanyuan, Chen Yan, Tang Hao, Liu Zichen, Mi Peng, Lin Xiangmin

机构信息

Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China; Heart Center and Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, China.

The First Affiliated Hospital of Baotou Medical College, No.41 Linyin Road, Kundulun District, Baotou City, Inner Mongolia, China.

出版信息

J Hum Hypertens. 2025 Jun 17. doi: 10.1038/s41371-025-01035-3.

Abstract

This multicenter, double-blind, parallel-group, randomised controlled phase III study evaluated the efficacy and safety of the Allisartan Isoproxil 240 mg /Amlodipine 5 mg (ALI/AML) combination compared with ALI 240 mg monotherapy in patients with mild-to-moderate essential hypertension. Patients aged 18 to 70 years with mean sitting systolic blood pressure (msSBP) between 140 and <180 mmHg and mean sitting diastolic blood pressure (msDBP) between 90 and <110 mmHg were randomised 1:1 to receive ALI/AML or ALI once-daily for 12 weeks after a 4-week treatment with ALI, followed by an open-label extension period with ALI/AML up to week 52. A total of 199 patients were randomised (ALI/AML: n = 99, ALI: n = 100) with 169 completing the study. Baseline characteristics were comparable between groups. After 12 weeks of randomisation, the reduction in msSBP (primary endpoint) was significantly greater in the ALI/AML group vs the ALI group (-18.3 vs. -9.3 mmHg, p < 0.001). Reductions in msDBP (-6.0 vs. -1.9 mmHg, p < 0.001) and 24-hour mean ambulatory systolic/diastolic blood pressure (-19.9/-10.1 vs. -6.9/-4.2 mmHg) were more pronounced in the ALI/AML group. Additionally, a greater proportion of patients achieved the BP response and target office BP in the ALI/AML group compared to the ALI group (53.6% vs. 25.5%, p < 0.001; 40.2% vs. 20.4%, p=0.0026). AML/ALI combination was generally safe and well tolerated, with sustained efficacy up to 52 weeks. The study concluded that ALI/AML offers a convenient, single-pill option for effective BP reduction in hypertensive patients.

摘要

这项多中心、双盲、平行组、随机对照III期研究评估了阿利沙坦酯240毫克/氨氯地平5毫克(ALI/AML)联合用药与阿利沙坦酯240毫克单药治疗相比,在轻至中度原发性高血压患者中的疗效和安全性。年龄在18至70岁之间,平均坐位收缩压(msSBP)在140至<180 mmHg之间,平均坐位舒张压(msDBP)在90至<110 mmHg之间的患者,在接受4周阿利沙坦酯治疗后,按1:1随机分组,接受ALI/AML或阿利沙坦酯每日一次治疗12周,随后进入长达52周的阿利沙坦酯/氨氯地平开放标签延长期。共有199例患者被随机分组(ALI/AML组:n = 99,阿利沙坦酯组:n = 100),其中169例完成了研究。两组的基线特征具有可比性。随机分组12周后,ALI/AML组的msSBP降低幅度(主要终点)显著大于阿利沙坦酯组(-18.3对-9.3 mmHg,p < 0.001)。ALI/AML组的msDBP降低幅度(-6.0对-1.9 mmHg,p < 0.001)和24小时平均动态收缩压/舒张压降低幅度(-19.9/-10.1对-6.9/-4.2 mmHg)更为显著。此外,与阿利沙坦酯组相比,ALI/AML组达到血压反应和目标诊室血压的患者比例更高(53.6%对25.5%,p < 0.001;40.2%对20.4%,p = 0.0026)。阿利沙坦酯/氨氯地平联合用药总体安全且耐受性良好,长达52周均有持续疗效。该研究得出结论,ALI/AML为高血压患者有效降低血压提供了一种方便的单片制剂选择。

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