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Aliskiren: a clinical profile

Department of Nephrology and Hypertension, Friedrich Alexander University, Erlangen-Nürnberg, Erlangen, Germany, roland.schmieder{at}rzmail.uni-erlangen.de

Aliskiren is a novel oral antihypertensive agent, and the first in the new class of direct renin inhibitors. Here we review the key criteria that a new antihypertensive drug should possess, notably effective blood pressure lowering as monotherapy and combination therapy, 24-hour blood pressure control, safety and tolerability, end-organ protective effects, minimal drug interaction and efficacy during long-term use.

Aliskiren fulfils key criteria for a new antihypertensive agent.The drug demonstrates effective blood lowering in a number of studies as monotherapy and in combination with a thiazide diuretic (hydrochlorothiazide), an angiotensin-converting enzyme inhibitor (ramipril) and a calcium channel blocker (amlodipine). Other studies applying ambulatory blood pressure monitoring show that aliskiren maintains blood pressure control for more than 24 hours. Aliskiren, 150 mg and 300 mg have demonstrated a placebo-like safety and tolerability profile, with no interactions with a wide range of commonly used drugs. Three studies (AVOID, ALOFT and ALLAY) are ongoing properties. with aliskiren to assess end-organ protective properties.

Key Words: aliskiren • renin inhibitor • hypertension • antihypertensive agents

References

• Primatesta P., Poulter NR Improvement in hypertension management in England: results from the Health Survey for England 2003. J Hypertens 2006;24:1187-92.
• NICE Clinical Guideline 34. National Institute for Health and Clinical Excellence, June 2006. ISBN 1-84629-222-0. www.nice.org.uk
• Lewington S., Clarke R., Qizilbash N., Peto R., Collins R. for the Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-13.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Burke TA, Sturkenboom MC, Lu SE et al. Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice. J Hypertens 2006;24:1193-200.[Web of Science][Medline] [Order article via Infotrieve]
• Vaidyanathan S., Limoges D., Yeh C., Dieterich H. Aliskiren, an orally effective renin inhibitor, shows dose linear pharmacokinetics in healthy volunteers. Clin Pharmacol Ther 2006;79:64(PIII-23).
• Vaidyanathan S., Zhao C., Yeh C., Dieterich H. Pharmacokinetics and safety of the novel oral renin inhibitor aliskiren in patients with type 2 diabetes. Clin Pharmacol Ther 2006;79:64(PI-21).
• Azizi M., Webb R., Nussberger J., Hollenberg NK Renin inhibition with aliskiren: where are we now, and where are we going? J Hypertens 2006;24:243-56.[Web of Science][Medline] [Order article via Infotrieve]
• Dieterle W., Corynen S., Mann J. Effect of the oral renin inhibitor aliskiren on the pharmacokinetics and pharmacodynamics of a single dose of warfarin in healthy subjects. Br J Clin Pharmacol 2004;58:433-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Dieterle W., Corynen S., Vaidyanathan S., Mann J. Pharmacokinetic interactions of the oral renin inhibitor aliskiren with lovastatin, atenolol, celecoxib and cimetidine. Int J Clin Pharmacol Ther 2005;43:527-35.[Web of Science][Medline] [Order article via Infotrieve]
• Dieterich H., Kemp C., Vaidyanathan S., Yeh C. Aliskiren, the first in a new class of orally effective renin inhibitors, has no clinically significant drug interactions with digoxin in healthy volunteers. Clin Pharmacol Ther 2006;79:64(PIII-24).
• Dieterich H., Kemp C., Vaidyanathan S., Yeh C. Pharmacokinetic interaction of the oral renin inhibitor aliskiren with hydrochlorothiazide in healthy volunteers. Clin Pharmacol Ther 2006;79:12(PI-20). radman AH, Schmieder RE, Lins RL et al. Aliskiren, a
• Gradman AH, Schmieder RE, Lins RL et al. Aliskiren, a novel orally effective renin inhibitor, provides dose-dependent antihypertensive efficacy and placebo-like tolerability in hypertensive patients. Circulation 2005;111:1012-18.[Abstract/Free Full Text]
• Weir MR, Bush C., Zhang J. et al. Antihypertensive efficacy and safety of the oral renin inhibitor aliskiren in patients with hypertension: a pooled analysis. Oral presentation at WCC/ESC congress, Barcelona, Spain, 2-6 September, 2006 (Abstract 1796 ).
• Mitchell J., Oh B., Herron J. et al. Once-daily aliskiren provides effective, smooth 24-hour blood pressure control in patients with hypertension. J Clin Hypertens 2006;8(5 suppl. A):A93(P-209). Poster presented at ASH 2006.
• Villamil A., Chrysant S., Calhoun D. et al. The novel oral renin inhibitor aliskiren provides effective blood pressure control in patients with hypertension when used alone or in combination with hydrochlorothiazide. J Clin Hypertens 2006;8(5 suppl A):P-228.
• Calhoun D., Chrysant S., Villamil A. et al. The novel oral renin inhibitor aliskiren decreases plasma renin activity (PRA) and neutralizes hydrochlorothiazide-induced RAAS activation in hypertensive patients. J Clin Hypertens 2006;8(5):suppl A:P-168.
• Uresin Y., Taylor A., Kilo C. et al. Aliskiren, a novel renin inhibitor, has greater BP lowering than ramipril and additional BP lowering when combined with ramipril in patients with diabetes and hypertension. J Hypertens 2006:24(suppl 4):S82 (P4.269).
• Munger MA, Drummond W., Essop MR et al. Aliskiren as add-on to amlodipine provides significant additional blood pressure lowering without increased oedema associated with doubling the amlodipine dose. Abstract presented at WCC/ESC, Barcelona, Spain, 2-6 September, 2006 (P784).
• Sica D., Gradman A., Lederballe O. et al. Aliskiren, a novel renin inhibitor, is well tolerated and has sustained BP-lowering effects alone or in combination with HCTZ during long-term (52 weeks) treatment of hypertension. Abstract presented at WCC/ESC, Barcelona, Spain, 2-6 September, 2006 (P797).

Journal of Renin-Angiotensin-Aldosterone System, Vol. 7, No. 2 suppl, S16-S20 (2006)
DOI: 10.3317/jraas.2006.033


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This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Schmieder, R. E Search for Related Content PubMed Articles by Schmieder, R. E Social Bookmarking                         What's this?