One Better Than the Other

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Australian researchers are saying the angiotensin-converting enzyme (ACE) inhibitor perindopril (Aceon) is more effective than the calcium channel blocker nifedipine (Procardia) in slowing the progression of kidney disease in people with diabetes who have normal blood pressure.

According to research published in the May issue of the American Journal of Kidney Diseases, George Jerums, MD, and colleagues from the University of Melbourne in Victoria, Australia, randomized 42 people to treatment with either Aceon, slow-release Procardia or placebo. Thirty-three patients had a minimum of 24 months’ data, and 25 patients were followed up beyond 36 months.

After three years of treatment, average albumin excretion rates were 23 µg/min for the Aceon group, 122 µg/min for the Procardia group and 112 µg/min for the placebo group. In addition, only one Aceon-treated patient progressed to macroalbuminuria compared with four Procardia-treated and three placebo-treated patients. Also, seven Aceon-treated patients experienced a regression to normoalbuminuria compared with none of the other patients.

After Aceon treatment was discontinued, albumin excretion rates more than doubled during the first three months, while they remained about the same after discontinuing Procardia or placebo therapy.

Neither HbA1c nor cholesterol and triglyceride levels were changed.

The researchers concluded that long-term Aceon therapy is more effective than Procardia or placebo in delaying the progression of diabetic kidney disease and reducing albumin excretion rates to the normal range of 20 µg/min in type 1s with normal blood pressure and microalbuminuria.

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