Is azilsartan more effective than a fixed-dose combination in the treatment of hypertension?

This study investigated the effectiveness of azilsartan (AZN; Edarbi) compared to a drug combination in a fixed-dose tablet (FDT) for hypertension. They found that AZN was as effective as the FDT.

Managing blood pressure (BP) levels is important in patients with hypertension. There are a number of strategies to lower BP. There are a number of different types of drugs to reduce BP. These are called anti-hypertensives (AHTs). These are categorized based on their mechanism of action (MOA). Some patients struggle to maintain BP levels with one AHT. Taking multiple AHTs with different MOAs can improve BP. Some drug combinations have been formulated in a fixed-dose tablet (FDT).

Azilsartan (AZN) is an AHT that blocks the angiotensin II receptor (ARB). Some studies suggest that AZN is more effective than other ARBs. ARBs are popular in the management of hypertension. They are often prescribed as an FDT with other drugs. These include calcium channel blockers (CCBs) or diuretics. It is unclear if AZN is more effective than a FDT of ARB/CCB or ARB/diuretic. 

This study included 40 patients with hypertension. Prior to the study patients were taking a FDT of either an ARB/CCB or an ARB/diuretic. The diuretic in this study was hydrochlorothiazide (HCT). All patients switched to 40 mg AZN per day. Treatment continued for 24 weeks. BP was measured at home every day and at clinic visits.

There was no significant change in BP at the end of the AZN treatment period. 84% of patients did not need another drug added to AZN treatment. 7 patients reported an increase in BP at 12 weeks. These patients were prescribed 5 mg of amlodipine (a CCB) to control BP. The level of potassium in the blood increased significantly at 24 weeks.

The authors concluded that AZN was as effective as a FDT for the treatment of hypertension.

This was a small study. Larger studies are needed to investigate the effectiveness of AZN. This study was funded by Takeda Pharmaceutical Co., the manufacturer of AZN.

If you have any concerns regarding hypertension treatment, please discuss this with your doctor.