Triplet therapy of telmisartan, amlodipine, and indapamide shows superior blood pressure control in hypertension management
1. Mean reduction in home systolic blood pressure at 12 weeks was greater with GMRx2 than with dual combination therapy.
2. Clinic blood pressure control was superior with GMRx2.
Evidence Rating Level: 1 (Excellent)
Study Rundown: Single-pill combinations (SPCs) of three low-dose antihypertensive drugs may help improve blood pressure control. GMRx2 is a novel triple-drug SPC containing telmisartan, amlodipine, and indapamide. This randomized controlled trial aimed to assess the efficacy and safety of GMRx2 compared to dual combination therapy for hypertension. The primary outcome was mean change in home systolic blood pressure (SBP) from baseline to 12 weeks, while the key secondary outcome was a difference in clinic and home blood pressure rates. According to study results, triplet combination of GMRx2 significantly reduced blood pressure compared to dual combinations. Although this study was well done, it was limited by a relatively short follow-up period.
Click to read the study in The Lancet
Relevant Reading: Telmisartan to Prevent Recurrent Stroke and Cardiovascular Events
In-depth [randomized-controlled trial]: Between Jul 9, 2021, and Sept 1, 2023, 3109 patients were screened for eligibility from 7 countries. Included were hypertensive patients taking up to 3 drugs with SBP ranging from 140-179 mmHg (untreated) to 110-150 mmHg (treated). Altogether, 1385 patients (551 to GMRx2, 276 to telmisartan-indapamide, 282 to telmisartan-amlodipine, and 276 to amlodipine-indapamide) were included in the final analysis. The primary outcome of mean change in home SBP at 12 weeks showed a greater reduction with GMRx2 (mean SBP 126 mmHg) compared to dual combinations (-2.5 vs. telmisartan-indapamide, -5.4 vs. telmisartan-amlodipine, -4.4 vs. amlodipine-indapamide, all p<0.0001). The secondary outcome of clinic blood pressure control was superior with GMRx2 (74% of patients achieved blood pressure levels below 140/90 mmHg vs. 53-61% in the dual-combination group). Findings from this study suggest that the triple combination pill GMRx2 provides an effective and well-tolerated option for improved blood pressure control in patients with hypertension.
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