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Nebivolol/Valsartan: A Novel Antihypertensive Fixed-Dose Combination Tablet
Dawn Battise1,2, Cassie L Boland1,3, Donald S Nuzum1,4
11 Wingate University School of Pharmacy, Wingate, NC, USA.
The Annals of Pharmacotherapy
|November 20, 2018
Summary
The nebivolol/valsartan combination significantly lowers blood pressure (BP) compared to individual treatments for hypertension. However, it may not offer superior clinical benefits for managing hypertension beyond reducing pill burden.
Area of Science:
- Pharmacology and Therapeutics
- Cardiovascular Medicine
Background:
- Hypertension (HTN) management often requires combination therapy.
- Beta-adrenergic antagonists and angiotensin II type 1 receptor blockers are common antihypertensives.
- Previous considerations suggested limited efficacy for combining these drug classes due to overlapping mechanisms.
Purpose of the Study:
- To review the pharmacology, pharmacokinetics, efficacy, safety, and therapeutic role of nebivolol/valsartan.
- To assess the clinical relevance of nebivolol/valsartan as a novel combination product for hypertension management.
Main Methods:
- A comprehensive PubMed search (1966-2018) was performed using keywords: nebivolol, valsartan, and hypertension.
- Inclusion criteria focused on English articles evaluating nebivolol/valsartan in human subjects.
- Data synthesis involved analyzing randomized trials and substudy findings.
Main Results:
- A phase III randomized trial showed statistically significant blood pressure (BP) lowering with nebivolol/valsartan versus monotherapy or placebo.
- Subanalyses indicated decreased plasma renin and aldosterone levels with the combination.
- One trial reported sustained BP lowering at 52 weeks, with similar additivity to other antihypertensive combinations.
Conclusions:
- The nebivolol/valsartan combination may benefit patients needing both drug classes who wish to reduce pill burden.
- While statistically significant BP reduction was observed, clinically significant advantages over existing therapies for hypertension management were not demonstrated.
- The combination's role in hypertension management requires careful consideration of its benefits and limitations.
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