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Первое поколение сартанов: есть ли перспективы?
Первое поколение сартанов: есть ли перспективы?
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Аннотация
Блокаторы рецепторов АТ1 (БРА) являются в настоящее время одним из основных классов антигипертензивных препаратов для лечения артериальной гипертензии. Телмисартан – структурно уникальный бифункциональный БРА, который в среднетерапевтических дозах частично активирует PPARγ-рецепторы, ответственные за регуляцию липидного и углеводного обмена. За счет второго механизма действия телмисартан способен уменьшить величину глюкозы, инсулина и триглицеридов в плазме крови. В отличие от I поколения и пероральных антиантидиабетических препаратов, лекарства, которые могут одновременно блокировать рецепторы к ангиотензину II и активировать PPARγ-рецепторы, могут обеспечить уникальную возможность лечения сердечно-сосудистых заболеваний и предотвращения сахарного диабета типа 2.
Ключевые слова: телмисартан, второе поколение БРА, предотвращение сахарного диабета.
Key words: telmisartan, second generation of the ARB, diabetes prevention.
Ключевые слова: телмисартан, второе поколение БРА, предотвращение сахарного диабета.
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Key words: telmisartan, second generation of the ARB, diabetes prevention.
Полный текст
Список литературы
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33. Kurtz T, Klein U. Next generation multifunctional angiotensin receptor blockers. Hypertens Res 2009; 32 (10): 826–34.
2. Ram C. Angiotensin receptor blockers: current status and future prospects. Am J Med 2008; 121: 656–63.
3. McMurray J. ACE inhibitors in cardiovascular disease – unbeatable? N Engl J Med 2008; 358: 1615–6.
4. Kakuta H et al. Telmisartan has the strongest binding affinity to angiotensin II type 1 receptor: comparison with other angiotensin II type 1 receptor blockers. Int J Clin Pharmacol Res 2005; 25: 41–6.
5. Wienen W et al. Pharmacological characterization of the novel nonpeptide angiotensin II receptor antagonist, BIBR 277. Br J Pharmacol 1993; 110: 245–52.
6. Burnier M, Brunner HR. Angiotensin II receptor antagonists. Lancet 2000; 355: 637–45.
7. Brunner HR. The new oral angiotensin II antagonist olmesartan medoxomil: a concise overview. J Hum Hypertens 2002; 16 (Suppl. 2): S13–6.
8. Диагностика и лечение артериальной гипертензии. Российские рекомендации (4-й пересмотр). Системн. гипертенз. 2010; 3: 3–25.
9. Benson S, Pershadsingh H, Ho C et al. Identification of telmisartan as a unique angiotensin II receptor antagonist with selective PPARgamma-modulating activity. Hypertension 2004; 43 (5): 993–1002.
10. Iwai M, Chen R, Imura Y, Horiuchi M. TAK-536, a new AT1 receptor blocker, improves glucose intolerance and adipocyte differentiation. Am J Hypertens 2007; 20: 579–86.
11. Hamaguchi Y, Uchii M, Matsubara M et al. A novel ARB with insulin-sensitizing activity, K-868, prevents diabetic nephropathy in rats. Diabetes 2009; 58: A208–9.
12. Pfizer Inc. PF-03838135 non-confidential summary. 2008.
13. Allegretti P, Choi K, Fatheree P et al. Dual-acting benzoimidazole antihypertensive agents. US patent application publication, US 2008/03189512008.
14. Feng L, Godtfredsen S, Karpinski P et al. Pharmaceutical combinations of an angiotensin receptor antagonist and an NEP inhibitor. PCT International Application Publication 2007, WO 2007/056546 A1.
15. Al-Fayoumi S, Hu J, Kumaraperumal N et al. Dual-acting pharmaceutical compositions based on superstructures of angiotensin receptor antagonist/blocker (ARB) and neutral endopeptidase (NEP) inhibitor. PCT International Application Publication 2009, WO 2009/0061713 A1.
16. Floyd D, Sills M. Pre-clinical development of PS433540, a dual-acting receptor antagonist (DARA) of the angiotensin and endothelin receptors. J Clin Hypertens 2007; 9 (Suppl. A): A158.
17. Li Y, Ji H, Zhang Y et al. WB1106, a novel nitric oxide-releasing derivative of telmisartan, inhibits hypertension and improves glucose metabolism in rats. Eur J Pharmacol 2007; 577: 100–8.
18. Yusuf S, Teo K, Pogue J et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med 2008; 358: 1547–59.
19. Maillard M, Wurzner G, Nussberger J et al. Comparative angiotensin II receptor blockade in healthy volunteers: the importance of dosing. Clin Pharmacol Ther 2002; 71: 68–76.
20. Elliott W, Meyer P. Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis. Lancet 2007; 369: 201–7.
21. Gress T, Nieto F, Shahar E et al. Hypertension and antihypertensive therapy as risk factors for type 2 diabetes mellitus. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342: 905–12.
22. Kjeldsen S, Naditch-Brule L, Perlini S et al. Increased prevalence of metabolic syndrome in uncontrolled hypertension across Europe: the Global Cardio-metabolic Risk Profile in Patients with hypertension disease survey. J Hypertens 2008; 26: 2064–70.
23. Shargorodsky M, Hass E, Boaz M et al. High dose treatment with angiotensin II receptor blocker in patients with hypertension: differential effect of tissue protection versus blood pressure lowering. Atherosclerosis 2008; 197: 303–10.
24. Hollenberg N, Parving H, Viberti G et al. Albuminuria response to very high-dose valsartan in type 2 diabetes mellitus. J Hypertens 2007; 25: 1921–6.
25. Kaplan NM. Combination therapy for hypertension. Nat Rev Cardiol 2009; 6: 270–1.
26. Neutel JM. Prescribing patterns in hypertension: the emerging role of fixed-dose combinations for attaining BP goals in hypertensive patients. Current Medical Research and Opinion 2008; 24: 2389–401.
27. Schupp M, Janke J, Clasen R et al. Angiotensin type 1 receptor blockers induce peroxisome proliferator-activated receptor-gamma activity. Circulation 2004; 109: 2054–7.
28. Schupp M, Clemenz M, Gineste R et al. Molecular characterization of new selective peroxisome proliferator-activated receptor-gamma modulators with angiotensin receptor blocking activity. Diabetes 2005; 54: 3442–52.
29. Lithell H, Hansson L, Skoog I et al. The Study on Cognition and Prognosis in the Elderly (SCOPE): principal results of a randomized double-blind intervention trial. J Hypertens 2003; 21: 875–86.
30. Российский статистический ежегодник. Федеральная служба государственной статистики. Официальное издание, 2009.
31. Yusuf S, Teo K, Anderson C et al. Effects of the angiotensin-receptor blocker telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomised controlled trial. Lancet 2008; 372: 1174–83.
32. Yusuf S, Diener H, Sacco R et al. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 2008; 359: 1225–37.
33. Kurtz T, Klein U. Next generation multifunctional angiotensin receptor blockers. Hypertens Res 2009; 32 (10): 826–34.
Авторы
И.Е.Чазова, Л.Г.Ратова
ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития
FS1 Russian cardiology scientific and production complex, Moscow
ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития
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FS1 Russian cardiology scientific and production complex, Moscow
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