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PP.21.16: META-ANALYSIS OF OLMESARTAN-BASED SINGLE PILL COMBINATION VERSUS MONOTHERAPY FOR REDUCING BLOOD PRESSURE

Objective: Most patients require 2 or more antihypertensive agents to achieve blood pressure (BP) goal. Single pill combinations of olmesartan medoxomil (OM) with amlodipine (AML), azelnidipine (AZE) or hydrochlorothiazide (HCTZ) improved BP lowering and goal achievement in individual clinical trials. This meta-analysis evaluated OM monotherapy vs OM-single pill combinations on reducing BP and achieving BP goal. Design and method: A meta-analysis of 8 studies (between 2000 and 2008) from a clinical trials database was conducted. Studies had 1 or more dual therapy arms (OM/AML, OM/AZE or OM/HCTZ) and 1 or more OM monotherapy arms. Endpoints were mean change from baseline (BL; first treatment day) in seated cuff blood pressure (SeBP) at 12 weeks, and percent achieving BP < 140/90 mmHg or systolic BP (SBP) goal < 140 mmHg by end of study (EOS). Statistical analysis (2-way ANCOVA, study and treatment as factors, BL SBP as covariate) on absolute change on mean SBP from BL to EOS (last observation carried forward; LOCF) are presented. Results: Demographics and mean baseline BP for OM mono (N = 1955) vs single pill combinations (N = 4004) were similar (Table). Dual therapy resulted in a greater BP reduction vs monotherapy at EOS (treatment difference: -7/-4 mmHg; LOCF; Table) and enabled more patients to achieve BP goal < 140/90 mmHg or SBP goal < 140 mmHg. Forest Plot analysis of absolute change on SBP from BL showed a treatment difference of 5.74 mmHg (95%CI:4.68,6.79) favoring OM dual therapy (Figure). Conclusions: OM-single pill combinations result in clinically relevant greater BP reductions and goal achievement vs OM monotherapy in hypertensive patients. Figure. No caption available.