Simi Bridjit Gomaz, Jaykaran Charan, Amal Mohandas, Pravesh Aggarwal, Deepak Kumar, Dharmveer Yadav, Ravindra Shukla, Sneha Ambwani, Rimple Jeet Kaur
{"title":"替米沙坦与其他抗高血压药物比较的抗炎潜能:随机试验的次要结果","authors":"Simi Bridjit Gomaz, Jaykaran Charan, Amal Mohandas, Pravesh Aggarwal, Deepak Kumar, Dharmveer Yadav, Ravindra Shukla, Sneha Ambwani, Rimple Jeet Kaur","doi":"10.1007/s10787-025-01995-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Chronic low-grade inflammation plays a central role in the pathophysiology of both type 2 diabetes mellitus (T2DM) and hypertension, contributing to increased cardiovascular risk. Telmisartan, an angiotensin receptor blocker with partial peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist activity, may offer anti-inflammatory benefits in addition to its antihypertensive effects.</p><p><strong>Aims: </strong>This study compares the effects of telmisartan versus other standard antihypertensive agents on inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), in patients with diabetes and newly diagnosed hypertension.</p><p><strong>Methods: </strong>This is a randomized, open-label, parallel-group, active-controlled trial. Seventy eligible patients were randomized to receive telmisartan (N = 34) or another antihypertensive agent [amlodipine (n = 22), cilnidipine (n = 12), or ramipril (n = 2)] (N = 36). Secondary outcome parameters included inflammatory biomarkers such as highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-α) measured at baseline and 12 weeks following treatment. Data are presented as median and interquartile range (IQR). Between-group comparisons at 12 weeks were performed using the Mann-Whitney U test. The trial is registered with the Clinical Trial Registry of India (CTRI/2023/04/051878).</p><p><strong>Results: </strong>At baseline, hsCRP, IL-6, and TNF-α levels were comparable between groups. In the telmisartan group, hsCRP declined from 3.4 mg/L (IQR: 2.0, 13.7) to 1.8 mg/L (IQR: 1.2, 5.0), IL-6 from 4.3 pg/mL (IQR: 2.9,9.5) to 3.4 pg/ml (IQR: 2.2, 6.8), and TNF-α from 19.4 pg/ml (IQR: 8.9, 43.7) to 13.8 pg/ml (IQR: 3.5, 32.4). In the active control group, hsCRP changed from 3.1 mg/L (IQR: 1.7, 8.0) to 2.9 mg/L (IQR: 1.7, 4.9), IL-6 from 4.1 pg/ml (IQR: 3.0,7.6) to 4.2 pg/ml (IQR: 2.9, 7.8), and TNF-α from 20.2 pg/ml (IQR: 10.4, 48.6) to 16.9 pg/ml (IQR: 3.3, 30.3). The differences between groups at 12 weeks were not statistically significant for hsCRP (P = 0.07), IL-6 (P = 0.24), or TNF-α (P = 0.93).</p><p><strong>Conclusion: </strong>The anti-inflammatory markers were reduced in both groups at 12 weeks without any statistically significant difference across groups. However, telmisartan was associated with greater reductions in hsCRP, IL-6, and TNF-α in patients with T2DM and hypertension following 12 weeks of treatment. These findings may indicate a potential anti-inflammatory effect of telmisartan that requires confirmation in adequately powered trials.</p>","PeriodicalId":13551,"journal":{"name":"Inflammopharmacology","volume":" ","pages":""},"PeriodicalIF":5.3000,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Anti-inflammatory potential of telmisartan compared to other antihypertensives: secondary outcomes from a randomized trial.\",\"authors\":\"Simi Bridjit Gomaz, Jaykaran Charan, Amal Mohandas, Pravesh Aggarwal, Deepak Kumar, Dharmveer Yadav, Ravindra Shukla, Sneha Ambwani, Rimple Jeet Kaur\",\"doi\":\"10.1007/s10787-025-01995-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Chronic low-grade inflammation plays a central role in the pathophysiology of both type 2 diabetes mellitus (T2DM) and hypertension, contributing to increased cardiovascular risk. Telmisartan, an angiotensin receptor blocker with partial peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist activity, may offer anti-inflammatory benefits in addition to its antihypertensive effects.</p><p><strong>Aims: </strong>This study compares the effects of telmisartan versus other standard antihypertensive agents on inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), in patients with diabetes and newly diagnosed hypertension.</p><p><strong>Methods: </strong>This is a randomized, open-label, parallel-group, active-controlled trial. Seventy eligible patients were randomized to receive telmisartan (N = 34) or another antihypertensive agent [amlodipine (n = 22), cilnidipine (n = 12), or ramipril (n = 2)] (N = 36). Secondary outcome parameters included inflammatory biomarkers such as highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-α) measured at baseline and 12 weeks following treatment. Data are presented as median and interquartile range (IQR). Between-group comparisons at 12 weeks were performed using the Mann-Whitney U test. The trial is registered with the Clinical Trial Registry of India (CTRI/2023/04/051878).</p><p><strong>Results: </strong>At baseline, hsCRP, IL-6, and TNF-α levels were comparable between groups. In the telmisartan group, hsCRP declined from 3.4 mg/L (IQR: 2.0, 13.7) to 1.8 mg/L (IQR: 1.2, 5.0), IL-6 from 4.3 pg/mL (IQR: 2.9,9.5) to 3.4 pg/ml (IQR: 2.2, 6.8), and TNF-α from 19.4 pg/ml (IQR: 8.9, 43.7) to 13.8 pg/ml (IQR: 3.5, 32.4). In the active control group, hsCRP changed from 3.1 mg/L (IQR: 1.7, 8.0) to 2.9 mg/L (IQR: 1.7, 4.9), IL-6 from 4.1 pg/ml (IQR: 3.0,7.6) to 4.2 pg/ml (IQR: 2.9, 7.8), and TNF-α from 20.2 pg/ml (IQR: 10.4, 48.6) to 16.9 pg/ml (IQR: 3.3, 30.3). The differences between groups at 12 weeks were not statistically significant for hsCRP (P = 0.07), IL-6 (P = 0.24), or TNF-α (P = 0.93).</p><p><strong>Conclusion: </strong>The anti-inflammatory markers were reduced in both groups at 12 weeks without any statistically significant difference across groups. However, telmisartan was associated with greater reductions in hsCRP, IL-6, and TNF-α in patients with T2DM and hypertension following 12 weeks of treatment. These findings may indicate a potential anti-inflammatory effect of telmisartan that requires confirmation in adequately powered trials.</p>\",\"PeriodicalId\":13551,\"journal\":{\"name\":\"Inflammopharmacology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":5.3000,\"publicationDate\":\"2025-10-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Inflammopharmacology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10787-025-01995-5\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Inflammopharmacology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10787-025-01995-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
Anti-inflammatory potential of telmisartan compared to other antihypertensives: secondary outcomes from a randomized trial.
Background: Chronic low-grade inflammation plays a central role in the pathophysiology of both type 2 diabetes mellitus (T2DM) and hypertension, contributing to increased cardiovascular risk. Telmisartan, an angiotensin receptor blocker with partial peroxisome proliferator-activated receptor gamma (PPAR-γ) agonist activity, may offer anti-inflammatory benefits in addition to its antihypertensive effects.
Aims: This study compares the effects of telmisartan versus other standard antihypertensive agents on inflammatory biomarkers, including high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α), in patients with diabetes and newly diagnosed hypertension.
Methods: This is a randomized, open-label, parallel-group, active-controlled trial. Seventy eligible patients were randomized to receive telmisartan (N = 34) or another antihypertensive agent [amlodipine (n = 22), cilnidipine (n = 12), or ramipril (n = 2)] (N = 36). Secondary outcome parameters included inflammatory biomarkers such as highly sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), and tumour necrosis factor alpha (TNF-α) measured at baseline and 12 weeks following treatment. Data are presented as median and interquartile range (IQR). Between-group comparisons at 12 weeks were performed using the Mann-Whitney U test. The trial is registered with the Clinical Trial Registry of India (CTRI/2023/04/051878).
Results: At baseline, hsCRP, IL-6, and TNF-α levels were comparable between groups. In the telmisartan group, hsCRP declined from 3.4 mg/L (IQR: 2.0, 13.7) to 1.8 mg/L (IQR: 1.2, 5.0), IL-6 from 4.3 pg/mL (IQR: 2.9,9.5) to 3.4 pg/ml (IQR: 2.2, 6.8), and TNF-α from 19.4 pg/ml (IQR: 8.9, 43.7) to 13.8 pg/ml (IQR: 3.5, 32.4). In the active control group, hsCRP changed from 3.1 mg/L (IQR: 1.7, 8.0) to 2.9 mg/L (IQR: 1.7, 4.9), IL-6 from 4.1 pg/ml (IQR: 3.0,7.6) to 4.2 pg/ml (IQR: 2.9, 7.8), and TNF-α from 20.2 pg/ml (IQR: 10.4, 48.6) to 16.9 pg/ml (IQR: 3.3, 30.3). The differences between groups at 12 weeks were not statistically significant for hsCRP (P = 0.07), IL-6 (P = 0.24), or TNF-α (P = 0.93).
Conclusion: The anti-inflammatory markers were reduced in both groups at 12 weeks without any statistically significant difference across groups. However, telmisartan was associated with greater reductions in hsCRP, IL-6, and TNF-α in patients with T2DM and hypertension following 12 weeks of treatment. These findings may indicate a potential anti-inflammatory effect of telmisartan that requires confirmation in adequately powered trials.
期刊介绍:
Inflammopharmacology is the official publication of the Gastrointestinal Section of the International Union of Basic and Clinical Pharmacology (IUPHAR) and the Hungarian Experimental and Clinical Pharmacology Society (HECPS). Inflammopharmacology publishes papers on all aspects of inflammation and its pharmacological control emphasizing comparisons of (a) different inflammatory states, and (b) the actions, therapeutic efficacy and safety of drugs employed in the treatment of inflammatory conditions. The comparative aspects of the types of inflammatory conditions include gastrointestinal disease (e.g. ulcerative colitis, Crohn''s disease), parasitic diseases, toxicological manifestations of the effects of drugs and environmental agents, arthritic conditions, and inflammatory effects of injury or aging on skeletal muscle. The journal has seven main interest areas:
-Drug-Disease Interactions - Conditional Pharmacology - i.e. where the condition (disease or stress state) influences the therapeutic response and side (adverse) effects from anti-inflammatory drugs. Mechanisms of drug-disease and drug disease interactions and the role of different stress states
-Rheumatology - particular emphasis on methods of measurement of clinical response effects of new agents, adverse effects from anti-rheumatic drugs
-Gastroenterology - with particular emphasis on animal and human models, mechanisms of mucosal inflammation and ulceration and effects of novel and established anti-ulcer, anti-inflammatory agents, or antiparasitic agents
-Neuro-Inflammation and Pain - model systems, pharmacology of new analgesic agents and mechanisms of neuro-inflammation and pain
-Novel drugs, natural products and nutraceuticals - and their effects on inflammatory processes, especially where there are indications of novel modes action compared with conventional drugs e.g. NSAIDs
-Muscle-immune interactions during inflammation [...]