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A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II

Journal of Human Hypertension volume 15, pages 475–480 (2001)Cite this article

Abstract

An 8-week, multicentre (72 sites in the US), double-blind, randomised, parallel group, forced titration study compared the antihypertensive efficacy of candesartan cilexetil and losartan. A total of 611 patients with essential hypertension (diastolic blood pressure 95 to 114 mm Hg) were randomised initially to candesartan cilexetil 16 mg once daily or losartan 50 mg once daily. After 2 weeks of randomised treatment, the doses of candesartan cilexetil and losartan were doubled to 32 mg and 100 mg once daily and continued respectively for 6 weeks. At week 8, candesartan cilexetil lowered the blood pressure (BP) at 24 h (trough), 6 h (peak) and 48 h post dose to a significantly greater extent (P < 0.05) than losartan: candesartan cilexetil lowered trough BP by 13.4/10.5 mm Hg, peak BP by 15.5/12.9 mm Hg and 48-h BP by 10.5/9.9 mm Hg compared to a reduction of trough BP by 10.1/9.1 mm Hg, peak BP by 12.0/9.5 mm Hg, and 48-h BP by 5.9/7.0 mm Hg by losartan. The responder and control rates were numerically higher in the candesartan cilexetil group, but the differences did not reach statistical significance; the responder rates were 58.8% for the candesartan cilexetil group and 52.1% for the losartan group and control rates were 49.0% for the candesartan cilexetil group and 44.6% for the losartan group. Overall, both treatment regimens were well tolerated. A total of 15 of the 611 (2.5%) patients withdrew from the study due to an adverse event, including nine (2.9%) in the candesartan cilexetil group and six (2.0%) in the losartan group. In conclusion, this forced titration study confirms that candesartan cilexetil is more effective in lowering BP than losartan when compared at once daily maximum doses.

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References

  1. Morsing P et alMechanistic differences of various AT1-receptor blockers in isolated vessels of different origin Hypertension 1999 33 1406–1413

    Article  CAS  Google Scholar 

  2. Vanderheyden PML, Fierens FLP, De Backer JP, Vauquelin G Reversible and syntopic interaction between angiotensin receptor antagonists on Chinese hasmster ovary cells expressing human angiotensin II type I receptors Biochem Pharmacol 2000 59 927–935

    Article  CAS  Google Scholar 

  3. Andersson OK, Neldam S The antihypertensive effect and tolerability of candesartan cilexetil, a new generation angiotensin II antagonist, in comparison with losartan Blood Pressure 1998 7 53–59

    Article  CAS  Google Scholar 

  4. Gradman AHet al,for the Candesartan Versus Losartan Efficacy Comparison (CANDLE) Study GroupComparative effects of candesartan cilexetil and losartan inpatients with systemic hypertension Heart Disease 1999 1 52–57

    CAS  PubMed  Google Scholar 

  5. Lacourciere Y, Asmar R, for the Candesartan/Losartan study investigators A comparison of the efficacy and duration of action of candesartan cilexetil and losartan as assessed by clinic and ambulatory blood pressure after a missed dose, in truly hypertensivepatients: a placebo-controlled, forced titration study Am J Hypertens 1999 12 1181–1187

    Article  CAS  Google Scholar 

  6. Bakris G et alAntihypertensive efficacy of candesartan in comparison to losartan: The CLAIM study J Clin Hypertens, 2001 3 16–21

    Article  CAS  Google Scholar 

  7. Physician's Desk Reference 54th edn. Medical Economics: Montvale (NJ), 2000. (a) Atacand (candesartan cilexetil), pp 592^594; (b) Cozzar (losartan) pp 1769–1772

  8. Munafo A et alDrug concentration response relationships in normal volunteers after oral administration of losartan, an angiotensin II receptor antagonist Clin Pharmacol Ther 1992 51 513–515

    Article  CAS  Google Scholar 

  9. Delacretaz E, Nussberger J, Biollaz J, Weber B, Brunner HR Characterization of the angiotensin II receptor antagonist TCV-116 in healthy volunteers Hypertension 1995 25 14–21

    Article  CAS  Google Scholar 

  10. Burnier M, Brunner HR Angiotensin II receptor antagonists Lancet 2000 355 637–645

    Article  CAS  Google Scholar 

  11. Fisher LD, Moye LA Carvedilol and the Food and Drug Administration approval process: an introduction Controlled Clin Trials 1999 20 1–15

    Article  CAS  Google Scholar 

  12. Conlin PR et alAngiotensin II antagonists for hypertension: are there differences in efficacy? Am J Hypertens 2000 13 418–426

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the diligent efforts of the clinical study coordinators at the 72 investigative sites. We also recognise the contributions of Channeary McDowell, BS, Jeanine Parsons, BS, Melissa Grozinski, BS, Anne Kezer, BS, Conrad Tou, PhD, Terry Flanagan MPH, James Gaddy, PhD, Oliver Yeh, BA and Debbie Brangman, MBA, for invaluable assistance in the conduct of the study and manuscript preparation.

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Authors and Affiliations

  1. Cleveland Clinic Foundation, Cleveland, OH, USA

    DG Vidt

  2. Section of Hypertension and Clinical Pharmacology, University of Connecticut Health Center, Farmington, CT, USA

    WB White

  3. Medical College of Virginia Commonwealth University, Richmond, VA, USA

    E Ridley

  4. Case Western Reserve University, Cleveland, OH, USA

    M Rahman

  5. AstraZeneca LP, Chesterbrook, PA, USA

    S Harris, J Vendetti, EL Michelson & R Wang

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  1. DG Vidt
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  2. WB White
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  6. J Vendetti
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  7. EL Michelson
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  8. R Wang
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and CLAIM Study investigators

Corresponding author

Correspondence to DG Vidt.

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Supported by a grant from AstraZeneca LP, Wayne, PA, USA

See Appendix

CLAIM Study 230 Investigators:

CLAIM Study 230 Investigators:

Frank G Baratta, MD, Ft Lauderdale, FL; Scott Blesser, DO, Midwest Regional Research Inc., Bellbrook, OH; Paul J Bresnan, MD, Watson Clinic LLP, Lakeland, FL; Joan Brigham, MD, ICSL-Clinical Studies, Charlotte, NC; David Calhoun, MD, University of Alabama at Birmingham, Birmingham, AL; Julian A Colton, MD, Health Advance Institute, St. Petersburg, FL; Martin Conway, MD, Lovelace Scientific Research, Albuquerque, NM; Pamela Craven, MD, Health Advance Institute, Oklahoma City, OK; William Cushman, MD, VAMC-Memphis, Memphis, TN; Stephen D’Amico, MD, GRAE, Inc, Franklin, TN; Vincent DeQuattro, MD, Los Angeles, CA; Lance D Dworkin, MD, Rhode Island Hospital, Providence, RI; David J. Frid, MD, OSU Center for Wellness and Prevention, Columbus, OH; Debra Ann Friesen, MD, Exempla Internal Medicine, Wheat Ridge, CO; W Thomas Garland, MD, Lawrence Clinical Research, Lawrenceville, NJ; Larry I Gilderman, DO, University Clinical Research Inc, Pembroke Pines, FL; Edward Gillie, MD, Medical Studies, Florida, Fort Myers, FL; Ivan Goldsmith, MD, West Trop Medical Centre, Las Vegas, NV; Ronald C Gove, MD, Jersey Research Foundation Inc, Linwood, NJ; Maria Gutierrez, MD, ICSL-Clinical Studies, Fort Lauderdale, FL; Kathy Harvey, DO, Internal Medicine, Logan, WV; Bradley Heppner, MD, ICSL-Clinical Studies, Pittsburgh, PA; John A Holmes, MD, Heart of America Research Institute, Mission, KS; E Walter Hood, DO, ICSL-Clinical Studies, Atlanta, GA; David B Jack, MD, Physicians Research Options, Sandy, UT; Edwin Jacobson, MD, Los Angeles, CA; Ashok Jain, MD, Dearborn, MI; Roy Kaplan, MD, East Bay Clinical Trial, Concord, CA; Edward M Kerwin, MD, Clinical Research Institute of Southern Oregon, LLC, Medford, OR; Robert Kloner, MD, Los Angeles Cardiology Assoc, Los Angeles, CA; Robert Leff, MD, Hill Top Argus Research Inc, Tuscon, AZ; Theodore E. Lefton, MD, ICSL-Clinical Studies, Melbourne, FL; Alan Levin, MD, Glenville, NY; Hari Malik, MD, Cedarwood Medical Center, St. Joseph, MI; Abe Marcadis, MD, ICSL-Clinical Studies, Boynton Beach, FL; R Eric McAllister, MD, MEDStudies Inc, Ukiah, CA; James McMechan, DO, Jefferson Country Medical Clinic PA, Oskaloosa, KS; John Mihalik, MD, Northern California Medical Associates, Cloverdale, CA; David Miller, MD, Bucks County Clinical Research, Moorisville, PA; Michael Miller, MD, University of MD School of Medicine, Baltimore, MD; Rafael Montoro, MD, Clinical Therapeutics Corp, Coral Gables, FL; Jane Mossberg, MD, Research Studies, Eugene, OR; William Mroczek, MD, Clinical Research of Northern Virginia, Falls Church, VA; David Mulholland, MD, Hill Top Med Quest Research, Greer, SC; Larry Neuman, MD, New York, NY; Margarita C Nunez, MD, ICSL-Clinical Studies, St. Petersburg, FL; Thomas O’Barr, MD, Health Advance Institute, Marietta, GA; Mark Okusa, MD, University of Virginia Medical Center, Charlottesville, VA; Vasilios Papademetriou, MD, VAMC-Hypertension Research Clinic, Washington, DC; Kavita Persaud, MD, St. Joseph Senior Health Services, Fort Wayne, PA; Frank Pettyjohn, MD, University of South Alabama, Mobile, AL; James L Pool, MD, Baylor College of Medicine Methodist Hospital, Houston, TX; Anthony Puopolo, MD, Milford Emergency Associates, Inc, Milford, MA; Promod Raval, MD, Oak Park, MI; Albert J Razzetti, MD, University Clinical Research-DeLand, DeLand, FL; Steven Rosansky, MD, Three Rivers Medical-Carolina Research Assoc, Columbia, SC; Herman Rose, MD, Fort Worth, TX; Eli Roth, MD, Sterling Research Group Ltd, Cincinnati, OH; Henry Rothschild, MD, Louisiana State University Medical Center, New Orleans, LA; John Rubino, MD, Raleigh Medical Group, Raleigh, NC; Susan Savage, MD, ICSL-Clinical Studies, Denver, CO; Kevin T Scully, MD, Lexington Cardiology Consultants, Lexington, KY; Stan Slabic, MD, Slabic & Slabic Internal Medicine, Erie, PA; William B Smith, MD, New Orleans Center for Clinical Research, New Orleans, LA; John A Stoukides, MD, ICSL-Clinical Studies, East Providence, RI; Malcolm Taylor, MD, Jackson Cardiology Associates, PA, Jackson, MS; Thomas Tse, MD, Bellville, IL; Margaret Wagner, MD, Idaho Falls, IN; Mervyn Weerasinghe, MD, Rochester Clinical Research, Rochester, NY; Susan Wehle, MD, ICSL-Clinical Studies, Brandon, FL; Gerald D Wolfley, MD, Hill Top Research Inc, Scottsdale, AZ.

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Vidt, D., White, W., Ridley, E. et al. A forced titration study of antihypertensive efficacy of candesartan cilexetil in comparison to losartan: CLAIM Study II. J Hum Hypertens 15, 475–480 (2001). https://doi.org/10.1038/sj.jhh.1001205

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