Research Activities January 2013, No. 389
Four drugs to treat chronic heart failure found similarly effective
Comparative Effectiveness Research
Thanks to their tolerability profiles, angiotensin receptor blockers (ARBs) are becoming the preferred medications to treat chronic heart failure (CHF). A new study that compared four ARBs to determine their ability to reduce mortality in patients with CHF found them to be similarly effective at reducing the death rate in everyday clinical practice.
The researchers identified 1,536 veterans with CHF from electronic medical records, with review of their medical charts providing additional clinical data. They categorized patients into one of four groups based on the ARB initially used: candesartan, valsartan, losartan, and irbesartan. They measured time to death during the study's 2-year period.
Of the 4 ARBs, irbesartan was the most popular, taken by 55.21 percent of patients. This was followed by losartan, candesartan, and valsartan. There was significant geographic variation in use of ARBs. For example, Midwest patients tended to use losartan and candesartan. However, no patients from the northeast were on candesartan and only two patients in the West were on valsartan. Concurrent hospitalization rates were higher for patients receiving irbesartan; valsartan had the lowest rate.
After the researchers controlled for numerous demographic and clinical factors, they found no statistically significant difference among the four ARBs in their ability to reduce mortality. The study was supported in part by the Agency for Healthcare Research and Quality (HS16901).
See "Comparative effectiveness of individual angiotensin receptor blockers on risk of mortality in patients with chronic heart failure," by Rishi J. Desai, MS, PhD, Carol M. Ashton, MD, MPH, Anita Deswal, MD, MPH, and others in Pharmacoepidemiology and Drug Safety 21, pp. 233-240, 2012.