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Telmisartan Improves Metabolic Parameters in Patients with Metabolic Syndrome

The first meta-analysis of randomized controlled trials using telmisartan in patients with metabolic syndrome provides promising results…. 

New research has found the angiotensin receptor blocker, telmisartan, to improve metabolic function in patients with metabolic syndrome. Recent information has proposed telmisartan improves cardiometabolic parameters due to its peroxisome proliferator-activated receptor-gamma-inducing property (PPAR-γ). The results of previously small randomized controlled trials of telmisartan therapy in patients with metabolic syndrome have found inconclusive effects on metabolic parameters. Takagi and colleagues conducted a meta-analysis of randomized controlled trials to determine whether or not telmisartan therapy improves aspects of metabolic syndrome.

Online databases, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were used to find appropriate trials. Eligible studies for inclusion met the following criteria: "the design was a prospective randomized controlled clinical trial (including a quasi-randomized crossover-design study); the study population was patients with metabolic syndrome; patients were randomly assigned to telmisartan versus control therapy (including placebo); and main outcomes included at least one of fasting glucose, insulin, and glycosylated hemoglobin (HbA1c) levels, homeostasis model assessment (HOMA) index, and adiponectin levels," reported Takagi H. et al.

A pooled analysis suggested significant improvement on metabolic parameters with the use of telmisartan. Reductions in percent changes compared to controls of fasting glucose were reported as the standardized mean difference of -0.51 favoring telmisartan. Insulin levels were reduced by 0.23%, glycosylated hemoglobin 0.26, and homeostasis model assessment index 0.22. A significant increase in percent changes of adiponectin (0.75) was also noted.

The author summarized their results by stating, "The present meta-analysis suggests reductions in fasting glucose and HbA1c as well as insulin levels with telmisartan therapy. In addition to the improvement of these measures of glycemia, our analysis also suggests that telmisartan therapy may reduce HOMA index, a measure of insulin resistance derived from fasting levels of glucose and insulin and a physiologically-based model."

Though the impact of telmisartan in patients with metabolic syndrome looks promising, the authors suggest the results of a large randomized control trial that confirms these clinical outcomes with the use of the drug is still needed.

Hisato T., Masao N., Yusuke M. et al., "Telmisartan as a metabolic sartan: The first meta-analysis of randomized controlled trials in metabolic syndrome." Journal of the American Society of Hypertension, Volume 7, Issue 3, May–June 2013, Pages 229–235.