Irbesartan treatment reduces biomarkers of inflammatory activity in patients with type 2 diabetes and microalbuminuria: an IRMA 2 substudy.

Abstract

The impact of irbesartan treatment on biomarkers of low-grade inflammation, endothelial dysfunction, growth factors, and advanced glycation end products (AGEs) during the Irbesartan in Patients with Type 2 Diabetes and Microalbuminuria (IRMA 2) study was evaluated. IRMA 2 was a 2-year multicenter, randomized, double-blind trial in patients comparing irbesartan (150 or 300 mg once daily) versus placebo. The primary end point was onset of overt nephropathy. A subgroup (n = 269, 68%) was analyzed for biomarkers at baseline and after 1 and 2 years. High-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, fibrinogen, adhesion molecules, transforming growth factor-beta, and AGE peptides were assessed. Irbesartan treatment yielded significant changes in hs-CRP (based on generalized estimating equation regression coefficient) with a 5.4% decrease per year versus a 10% increase per year in the placebo group (P < 0.001). Fibrinogen decreased 0.059 g/l per year from baseline versus placebo's 0.059 g/l increase per year (P = 0.027). IL-6 showed a 1.8% increase per year compared with placebo's 6.5% increase per year (P = 0.005). Changes in IL-6 were associated with changes in albumin excretion (P = 0.04). There was no treatment effect on the other biomarkers. Irbesartan (300 mg once daily) reduces low-grade inflammation in this high-risk population, and this may reduce the risk of micro- and macrovascular disease.

• Authors: Frederik Persson, Peter Rossing, Peter Hovind, Coen D A Stehouwer, Casper Schalkwijk, Lise Tarnow, Hans-Henrik Parving
• Journal: Diabetes (Diabetes) Vol. 55 Issue 12 Pg. 3550-5 (Dec 2006) ISSN: 0012-1797 [Print] United States
• PMID: 17130503 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Antihypertensive Agents
• Biomarkers
• Biphenyl Compounds
• Tetrazoles
• Irbesartan

Topics

• Aged
• Albuminuria
• Antihypertensive Agents (therapeutic use)
• Biomarkers (blood)
• Biphenyl Compounds (therapeutic use)
• Diabetes Mellitus, Type 2 (drug therapy, physiopathology, urine)
• Double-Blind Method
• Female
• Humans
• Inflammation (prevention & control)
• Irbesartan
• Male
• Middle Aged
• Tetrazoles (therapeutic use)