EFFICACY AND SAFETY OF AMLODIPINE AND BISOPROLOL IN HYPERTENSION TREATMENT- A SYSTEMATIC REVIEW
Author(s)
Fujii RK1, Restrepo M2, Pepe C3, Fernandes RA3, Haas L4, Junqueira M1
1Merck Serono, São Paulo, Brazil, 2Merck Serono, Bogota, Colombia, 3Grupo Resulta, São Paulo, Brazil, 4Sense Company, Rio de Janeiro, Brazil
OBJECTIVES: The complexity of therapy and pill burden has a direct impact on treatment compliance. Compliance is improved when agents are prescribed as fixed dose combinations rather than separate pills. This could be of particular value in elderly patients with multiple morbidities requiring polypharmacy. This systematic review aims to at evaluating efficacy and safety of the once-daily fixed-dose-combination (bisoprolol+amlodipine) on SAH. METHODS: Electronic searches included MEDLINE, LILACS, EMBASE, CRD, among others until June 2014. Search terms included “Amlodipine”, “Bisoprolol” and “Hypertension” via MESH controlled vocabulary. Where included studies with information on patients using the combination for hypertension treatment. Two reviewers performed the search. RESULTS: From 704 articles found, 3 evaluated efficacy. Mean reduction of 19.7% in DBP, from 103.9±9.6 mmHg at baseline to 83.4±6.2 mmHg (p<0.0001). SBP decreased from 20.4% to 21,8% and DBP decreased19.7% to 21.2%. SBP/DBP goal (<140/90 mmHg) was reached or exceeded from 82.5 to 89.0% of patients by the end of 8 weeks. HR presented reductions from 10.4% to 21.65% to the end of 8 weeks (from 87.3 ± 11.07 bpm to 68.4 ± 8.13 bpm). Pedal edema was observed in 7.5% to 8%. Excellent/good tolerability was reported by 90.6% to 94% of patients. Combination therapy is likely to cause fewer AEs with lower doses. Benefits of fixed-dose include reduced pill burden, improved BP control, compliance and cost savings. Persistence rate of 58.3% compared to 14.9% and a compliance rate of 76.9% versus 54.4% were observed. Patients with HR >79 bpm had an 89% greater risk of mortality than those with HR ≤79 bpm. CONCLUSIONS: In summary, bisoprolol plus amlodipine in a fixed-dose combination showed to improve response rate, with a similar safety profile when compared with amlodipine and bisoprolol in monotherapy, potentially leading to an increase in SAH treatment compliance.
Conference/Value in Health Info
2015-05, ISPOR 2015, Philadelphia, PA, USA
Value in Health, Vol. 18, No. 3 (May 2015)
Code
PCV16
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
Cardiovascular Disorders