Friday, December 30, 2011

ANOTHER NEW ANTI-HYPERTENSIVE COMBO PILL. THIS ONE WITH A DIFFERENCE

I have just read that the US FDA have just approved Edarbyclor by Takeda. This is a combination anti-hypertension pill combining Azilsartan ( an ARB by Takeda ) with chlorthalidone ( a diuretic ). So what, you may say. There are so many combo pills with ARB + diuretic in the marketplace. But please note that this one has chlorthalidone as a diuretic.
One of the great mysteries that I could not understand is why the big pharmas ( Novartis, Pfizer, Boeringher-I, Sanofi, AstraZ ) have all chosen to combine their ARB with hydrochlorthiazide ( HCT ), when all the clinical trials including head-head trials have shown that chlorthalidone is a better anti-hypertensive diuretic then hydrochlorthiazide. This was well shown in SHEP and ALLHAT. There were also a couple of head-head trials. They all concluded that chlorthalidone was a more effective anti-hypertensive than hydrochlorthiazide, with more event reductions too, not just BP control.
At least, Takeda has taken up the challenge, and we wait to see Edarbyclor on our shores. Nothing like how it works in our local population. So far, all the reports have been good. Azilsartan + chlorthalidone was better than Olmesartan and HCT in a head-head trial recently published.
Of course, for our patient's sake, the price will be affordable.

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