Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes: Results from ADVANCE in context of available evidence

John Chalmers, Rohina Joshi, Andre Pascal Kengne, Toshiharu Ninomiya, Yufang Bi, Severine Bompoint, Laurent Billot, Anushka Patel

Research output: Contribution to journalReview article

6 Citations (Scopus)

Abstract

Objectives The ADVANCE: trial was designed to determine the effects of routine blood pressure lowering using a fixed combination of perindopril-indapamide on major vascular outcomes in patients with type 2 diabetes, regardless of initial blood pressure levels or the use of other blood pressure-lowering drugs, including angiotensin-converting enzyme inhibitors. Methods: After a 6-week run-in period, 11140 high-risk individuals with type 2 diabetes were randomized to fixed combination perindopril-indapamide or matching placebo, in addition to current therapy. The two primary outcomes were composites of major macrovascular and major microvascular events, analysed jointly and separately by intention to treat. Results: The reduction in blood pressure in participants assigned to active treatment was 5.6/2.2 mmHg greater than that observed in the control group. Active treatment reduced the risk of the combined primary outcome, a major macrovascular or microvascular event by 9% (PU0.041) and resulted in a 14% (PU0.025) reduction in all-cause mortality and an 18% (PU0.027) reduction in cardiovascular mortality. There were reductions of 14% (PU0.02) in total coronary events and 21% (P<0.0001) in total renal events. The treatment was well tolerated, with 73% and 74% ofpatients in the active treatment and placebo groups still adherent to randomized therapy after an average of 4.3 years of follow-up. Conclusions: Routine treatment with the fixed combination of perindopril and indapamide was well tolerated and reduced the risk of death and major vascular events, regardless of the initial blood pressure level or concomitant treatments received. The results suggest that for every 79 patients treated in this manner, one death would be avoided over 5 years.

Original languageEnglish
JournalJournal of hypertension
Volume26
Issue numberSUPPL. 3
DOIs
Publication statusPublished - Sep 1 2008

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Indapamide
Perindopril
Type 2 Diabetes Mellitus
Safety
Blood Pressure
Therapeutics
Blood Vessels
Placebos
Mortality
Angiotensin-Converting Enzyme Inhibitors
Kidney
Control Groups

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes : Results from ADVANCE in context of available evidence. / Chalmers, John; Joshi, Rohina; Kengne, Andre Pascal; Ninomiya, Toshiharu; Bi, Yufang; Bompoint, Severine; Billot, Laurent; Patel, Anushka.

In: Journal of hypertension, Vol. 26, No. SUPPL. 3, 01.09.2008.

Research output: Contribution to journalReview article

Chalmers, John ; Joshi, Rohina ; Kengne, Andre Pascal ; Ninomiya, Toshiharu ; Bi, Yufang ; Bompoint, Severine ; Billot, Laurent ; Patel, Anushka. / Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes : Results from ADVANCE in context of available evidence. In: Journal of hypertension. 2008 ; Vol. 26, No. SUPPL. 3.
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abstract = "Objectives The ADVANCE: trial was designed to determine the effects of routine blood pressure lowering using a fixed combination of perindopril-indapamide on major vascular outcomes in patients with type 2 diabetes, regardless of initial blood pressure levels or the use of other blood pressure-lowering drugs, including angiotensin-converting enzyme inhibitors. Methods: After a 6-week run-in period, 11140 high-risk individuals with type 2 diabetes were randomized to fixed combination perindopril-indapamide or matching placebo, in addition to current therapy. The two primary outcomes were composites of major macrovascular and major microvascular events, analysed jointly and separately by intention to treat. Results: The reduction in blood pressure in participants assigned to active treatment was 5.6/2.2 mmHg greater than that observed in the control group. Active treatment reduced the risk of the combined primary outcome, a major macrovascular or microvascular event by 9{\%} (PU0.041) and resulted in a 14{\%} (PU0.025) reduction in all-cause mortality and an 18{\%} (PU0.027) reduction in cardiovascular mortality. There were reductions of 14{\%} (PU0.02) in total coronary events and 21{\%} (P<0.0001) in total renal events. The treatment was well tolerated, with 73{\%} and 74{\%} ofpatients in the active treatment and placebo groups still adherent to randomized therapy after an average of 4.3 years of follow-up. Conclusions: Routine treatment with the fixed combination of perindopril and indapamide was well tolerated and reduced the risk of death and major vascular events, regardless of the initial blood pressure level or concomitant treatments received. The results suggest that for every 79 patients treated in this manner, one death would be avoided over 5 years.",
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T1 - Efficacy and safety of fixed combination of perindopril and indapamide in type 2 diabetes

T2 - Results from ADVANCE in context of available evidence

AU - Chalmers, John

AU - Joshi, Rohina

AU - Kengne, Andre Pascal

AU - Ninomiya, Toshiharu

AU - Bi, Yufang

AU - Bompoint, Severine

AU - Billot, Laurent

AU - Patel, Anushka

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N2 - Objectives The ADVANCE: trial was designed to determine the effects of routine blood pressure lowering using a fixed combination of perindopril-indapamide on major vascular outcomes in patients with type 2 diabetes, regardless of initial blood pressure levels or the use of other blood pressure-lowering drugs, including angiotensin-converting enzyme inhibitors. Methods: After a 6-week run-in period, 11140 high-risk individuals with type 2 diabetes were randomized to fixed combination perindopril-indapamide or matching placebo, in addition to current therapy. The two primary outcomes were composites of major macrovascular and major microvascular events, analysed jointly and separately by intention to treat. Results: The reduction in blood pressure in participants assigned to active treatment was 5.6/2.2 mmHg greater than that observed in the control group. Active treatment reduced the risk of the combined primary outcome, a major macrovascular or microvascular event by 9% (PU0.041) and resulted in a 14% (PU0.025) reduction in all-cause mortality and an 18% (PU0.027) reduction in cardiovascular mortality. There were reductions of 14% (PU0.02) in total coronary events and 21% (P<0.0001) in total renal events. The treatment was well tolerated, with 73% and 74% ofpatients in the active treatment and placebo groups still adherent to randomized therapy after an average of 4.3 years of follow-up. Conclusions: Routine treatment with the fixed combination of perindopril and indapamide was well tolerated and reduced the risk of death and major vascular events, regardless of the initial blood pressure level or concomitant treatments received. The results suggest that for every 79 patients treated in this manner, one death would be avoided over 5 years.

AB - Objectives The ADVANCE: trial was designed to determine the effects of routine blood pressure lowering using a fixed combination of perindopril-indapamide on major vascular outcomes in patients with type 2 diabetes, regardless of initial blood pressure levels or the use of other blood pressure-lowering drugs, including angiotensin-converting enzyme inhibitors. Methods: After a 6-week run-in period, 11140 high-risk individuals with type 2 diabetes were randomized to fixed combination perindopril-indapamide or matching placebo, in addition to current therapy. The two primary outcomes were composites of major macrovascular and major microvascular events, analysed jointly and separately by intention to treat. Results: The reduction in blood pressure in participants assigned to active treatment was 5.6/2.2 mmHg greater than that observed in the control group. Active treatment reduced the risk of the combined primary outcome, a major macrovascular or microvascular event by 9% (PU0.041) and resulted in a 14% (PU0.025) reduction in all-cause mortality and an 18% (PU0.027) reduction in cardiovascular mortality. There were reductions of 14% (PU0.02) in total coronary events and 21% (P<0.0001) in total renal events. The treatment was well tolerated, with 73% and 74% ofpatients in the active treatment and placebo groups still adherent to randomized therapy after an average of 4.3 years of follow-up. Conclusions: Routine treatment with the fixed combination of perindopril and indapamide was well tolerated and reduced the risk of death and major vascular events, regardless of the initial blood pressure level or concomitant treatments received. The results suggest that for every 79 patients treated in this manner, one death would be avoided over 5 years.

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