Azilsartan: the novel ARB with unique mechanism of action
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20170458Keywords:
ARBs, Azilsartan, Angiotensin, Hypertension, MasAbstract
Hypertension is attributed to be one of the major risk factors in the pathophysiology of ischemic heart disease, stroke, heart failure and renal dysfunction. Angiotensin receptor blockers (ARBs) are one of the first line drugs recommended for clinical use in hypertension by JNC 8. Azilsartan is the recent addition to this family of ARBs and is perceived as one of the potent antihypertensive drugs today. Azilsartan was developed by replacing the tetrazole ring in candesartan with a 5 member oxo-oxadiazole ring. In India Azisartan was recently approved by DCGI in December 2016 for use in hypertension. In various randomized, double blind clinical studies Azilsartan was found to be to be superior in terms of clinical efficacy over other ARBs like Candesartan, Olmesartan and Valsartan and angiotensin converting enzyme inhibitor like Ramipril. In terms of safety profile Azilsartan appears to be equivalent to the currently available ARBs. Azilsartan due to its superior efficacy and comparative safety profile appear to be a new addition to the armamentarium in the treatment of hypertension.
Metrics
References
Centers for Disease Control and Prevention. High Blood Pressure Facts. Atlanta, GA: Centers for Disease Control and Prevention; 2011. Available from: http://www.cdc.gov/bloodpressure/facts.htm. Accessed Jan 11, 2017.
Antonakoudis G, Poulimenos I, Kifnidis K, Zouras C, Antonakoudis H. Blood pressure control and cardiovascular risk reduction. Hippokratia. 2007;11(3):114-9.
Ripley E, Hirsch A. Fifteen years of losartan: what have we learned about losartan that can benefit chronic kidney disease patients? Int J Nephrol Renovasc Dis. 2010;3:93-8.
DCGI Approval for Azilsartan. http://www.cdsco.nic.in/forms/list.aspx?lid=2034&Id=11. Accessed on 05/01/2017).
Kurtz TW. Kajiya T. Differential pharmacology and benefit/risk of azilsartan compared to other sartans. Vasc Health Risk Manag. 2012;8:133-43.
Carroll MA. Kang Y. Chander PN. Stier CT. Azilsartan is associated with increased circulating Angiotensin-(1-7) levels and reduced renovascular 20-HETE levels. Am J Hypertens. 2015;28(5):664-71.
Simoes e Silva AC, Silveira KD, Ferreira AJ, Teixeira MM. ACE2, angiotensin-(1-7) and Mas receptor axis in inflammation and fibrosis. British journal of pharmacology. 2013;169(3):477-92.
deGodoy MAF, Pernomian L, de Oliviera AM, Rattan S. Biosynthetic Pathways and the Role of the MasReceptor in the Effects of Angiotensin-(1-7) in Smooth Muscles. International Journal of Hypertension. 2012;121740.
Young D, Waitches G, Birchmeier C. Isolation and characterization of a new cellular oncogene encoding a protein with multiple potential transmembrane domains. Cell. 1986;45(5):711-9.
Product Information: Edarbi oral tablets, azilsartan medoxomil oral tablets. Takeda Pharmaceuticals America, Inc., https://www.edarbi.com/media/pdf/EDARBI-PI.pdf. Accessed on 11/01/17.
Kajiya T, Ho C, Wang J. Molecular and cellular effects of azilsartan: A new generation angiotensin II receptor blocker. J Hypertens. 2011;29:2476-83.
Zhao M, Li Y, Wang J. Azilsartan treatment improves insulin sensitivity in obese spontaneously hypertensive Koletsky rats. Diabetes Obes Metab. 2011;13:1123-9.
Hye Khan MA, Neckar J, Haines J, Imig JD. Azilsartan improves glycemic status and reduces kidney damage in zucker diabetic fatty rats. Am J Hypertens. 2014;27(8):1087-95.
Abdelsaid M, Coucha M, Ergul A. Cerebrovasculo protective Effects of azilsartan medoxomil in diabetes. Transl Res. 2014;164(5):424-32.
Tarikuz Zaman AK, McLean DL, Sobel BE. The efficacy and tolerability of azilsartan in obese insulin-resistant mice with left ventricular pressure overload. J Cardiovasc Pharmacol. 2013;62(4):381-7.
Nakamura Y, Suzuki S, Saitoh S, Takeishi Y. New angiotensin II type 1 receptor blocker, azilsartan, attenuates cardiac remodeling after myocardial infarction. Biol Pharm Bull. 2013;36(8):1326-31.
Khan AH, Neckar J, Cummens B, Wahl GM, Imig JD. Azilsartan decreases renal and cardiovascular injury in the spontaneously hypertensive obese rat. Cardiovasc Drugs Ther. 2014;28:313-22.
Bakris GL, Sica D, White WB, Cushman WC, Weber MA, Handley A et al. Antihypertensive efficacy of hydrochlorothiazide vs chlorthalidone combined with azilsartan medoxomil. Am J Med. 2012;125(12):1229.e1-e10.
White WB, Cuadra RH, Lloyd E, Bakris GL, Kupfer S. Effects of azilsartan medoxomil compared with olmesartan and valsartan on ambulatory and clinic blood pressure in patients with type 2 diabetes and prediabetes. J Hypertens. 2016;34(4):788-97.
Sica D, White WB, Weber MA, Bakris GL, Perez A, Cao C et al. Comparison of the novel angiotensin II receptor blocker azilsartan medoxomil vs valsartan by ambulatory blood pressure monitoring. J Clin Hypertens (Greenwich). 2011;13(7):467-72.
Bönner G, Bakris GL, Sica D, Weber MA, White WB, Perez A et al. Antihypertensive efficacy of the angiotensin receptor blocker azilsartan medoxomil compared with the angiotensin-converting enzyme inhibitor ramipril. J Hum Hypertens. 2013;27(8):479-86.
Sica D, Bakris GL, White WB, Weber MA, Cushman WC, Huang P et al. Blood pressure-lowering efficacy of the fixed-dose combination of azilsartan medoxomil and chlorthalidone: a factorial study. J Clin Hypertens (Greenwich). 2012;14(5):284-92.
Weber MA, White WB, Sica D, Bakris GL, Cao C, Roberts A et al. Effects of combining azilsartan medoxomil with amlodipine in patients with stage 2 hypertension. Blood Press Monit. 2014;19(2):90-7.
Downloads
Published
How to Cite
Issue
Section
