ONTARGET Trial Programme

ONTARGET^® (The Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial) was one of the largest, most ambitious ARB clinical study programmes ever undertaken. 25,620 patients from 733 centres in 41 countries were randomised for 5.5 years of treatment of either Pritor^®/Kinzal^® (telmisartan), the ACE inhibitor ramipril or a combination of the two.

The study aimed to investigate the role of Pritor^®/Kinzal^® and the combination of Pritor^®/Kinzal^® and ramipril in CV protection through the primary composite outcome of death from CV causes, myocardial infarction, stroke or hospilisation for heart failure, in high CV risk patients.

Results

The results revealed that Pritor^®/Kinzal^® is as effective as the current gold standard ramipril but with better tolerability.

The primary composite outcome occurred in 16.5% patients in the ramipril group compared with 16.7% patients in the Pritor^®/Kinzal^® group (relative risk, 1.01; 95% confidence interval [CI], 0.94 to 1.09).

There were more discontinuations in the ramipril group than in the Pritor^®/Kinzal^® group due to angio-oedema (0.1% vs. 0.3%, p=0.01) and cough (1.1% vs. 4.2%, p<0.001). More patients in the Pritor^®/Kinzal^® group discontinued because of hypotensive symptoms (2.6% vs. 1.7%, p<0.001), however this did not result in more syncope (0.2% in both groups, p=0.49). Increased tolerability also resulted in greater compliance with Pritor^®/Kinzal^® treatment.

The combination of the two drugs was associated with more adverse events without an increase in protective benefit. As compared with the ramipril group, there was a significantly increased risk of hypotensive symptoms (4.8% vs. 1.7%, p<0.001), syncope (0.3% vs. 0.2%, p=0.03), and renal dysfunction (13.5% vs. 10.2%, p<0.001) with the combination.

To view expert opinions on the ONTARGET^® results on www.ICMAedu.com click here.

For more information on ONTARGET^® along with detailed data and opinions from leading experts on the potential implications for clinical practice, please visit www.ICMAedu.com.

References:

1 The ONTARGET Investigators. Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events. N Engl J Med 2008;358:1547-59.

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