Envisioning 2.0

Novartis has been touting its new rennin inhibitor Aliskiren as a new breakthrough in high blood pressure treatment, but some prominent physicians disagree. Drs. John Laragh and Jean E. Sealey conducted an analysis of six Aliskiren clinical trials and concluded that the drug is no better at lowering blood pressure than older treatments. However, some researchers are questioning their analysis because is partly based on the measurement of plasma rennin levels. Renin, an enzyme produced by the kidneys, helps to regulate blood pressure.

Laragh and Sealey concluded that: “aliskiren in combination with a diuretic appeared to lower blood pressure more than an aliskiren-angiotensin receptor blocker combination, but still failed to control blood pressure (<140/90) in 50% of . . . patients.” In addition, they assert that “while Aliskiren suppresses from 90% to 95% of plasma renin activity . . . it also causes significantly larger reactive rises in plasma renin concentrations than [other high blood pressure] drugs . . . an effect that cancels out its blood-pressure lowering effects.”

Dr. Matthew Weir, who helped to test Aliskiren in clinical trials disagreed with Laragh and Sealey’s assessment, saying:

“The claim that renin inhibitors are equally effective as other blood pressure drugs is true . . . [however] [t]hey’re creating hypotheses about how drugs affect the renin-angiotensin system, and in particular they’re referring to renin levels, which no one measures.”

Laragh & Sealey Tout Generics; Some Docs Sit On Fence

Laragh and Sealey conducted this analysis in part in order to make the case that older, cheaper blood pressure medications are just as effective as newer products. They say that diuretics (water pills) and other medications are safer and when “properly targeted” are “broadly effective.”

Other physicians are taking a wait and see attitude toward Aliskerin. Dr. Bob Centor, who writes DB’s Med Rants said that he normally waits a year before using any new medication. While “this class may [or may not] represent a major benefit,” he said. “We need to follow the literature and learn about this drug over time.

This entry was posted on May 14, 2007 at 12:30 pm and is filed under The Pharmaceutical Industry. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.