Issue 121 Item 12 ESC: Losartan Reduces Incidence of End-Stage Renal Disease

Researchers have found that losartan, an angiotensin II receptor blocker, can protect diabetic patients with nephropathy from end-stage renal disease. 44,000 cases could have been prevented over 3.5 years. >Reported at ESC, European Society of Cardiology (ESC) in Berlin, Germany, the findings, if put into action, could have widespread public health and economic effects.

"Treatment with losartan in patients with type 2 diabetes and nephropathy not only reduces the incidence of end-stage renal disease, but also may result in substantial cost savings," said William Gerth, a researcher with Merck & Co., Inc., New Jersey, United States. Dr. Gerth and colleagues presented these findings at the 24th annual congress of the

Using data developed during the RENAAL (Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan) trial, Dr. Gerth estimated that in countries within the European Union, treatment of patients with losartan would produce a savings of 5,189 euros after four years. That is based on a cost estimate of 8,420 euros for 3.5 years of treatment. Dr. Gerth estimated that the end-stage renal disease cost over the same period for placebo patients was about 12,138 euros.

In the RENAAL study, a randomized, double blind, multinational clinical trial, patients received either losartan or a placebo in addition to conventional (non-ACE/AIIA) antihypertensive therapy. The study aimed to determine if losartan treatment could slow the progression of renal disease in patients with diabetes mellitus.

Results showed that losartan reduced the incidence of the doubling of serum creatinine, end-stage renal disease or death by a statistically significant 16 percent. Much of that difference is due to the drug’s ability to reduce the incidence of end-stage renal disease — defined as the initiation of dialysis or transplantation — by 28.6 percent.

Calculating how the use of losartan would impact 15 European Union countries, Dr. Gerth found that after 3.5 years about 44,100 cases of end-stage renal disease could have been avoided if eligible patients were put on the treatment protocol. That would also mean 64,400 years of end-stage renal disease would have been avoided among the roughly 17 million people in those countries who have diabetes.