NEW DRUG RESEARCH

Data presented in Barcelona, Spain, at the 21st Congress of the European Society of Cardiology, about new and investigational heart medications, could improve the treatment of diabetic ramifications. We have not seen a full list of the papers presented last August and September, but two studies already stand out.

In the first, the HOPE (Heart Outcomes Prevention Evaluation) study showed that the anti-hypertensive blood-pressure medication ramipiril (Altace), an ACE Inhibitor like those already recommended for management of diabetic End Stage Renal Disease (ESRD), has significant cardiovascular benefits, for both hypertensive patients and those with normal blood pressure. The study showed a 15 percent reduction in the need for revascularization (coronary angioplasty, coronary artery bypass graft, peripheral angioplasty) with ramipiril; a 22 percent risk reduction in stroke, heart attack and cardiovascular death; and, among participants who had not developed overt diabetes by the study's start (1994), a significantly smaller number of those taking ramipiril did so during the study than did those receiving the placebo. Note: Altace has been available in the United States since 1991.

The other study of interest to diabetics was of the new Angiotensin II Receptor Antagonist medication Teveten(R), eprosartan mesylate. Although most of its Barcelona presentation concerned its effect on blood pressure, the presenters did state their preliminary data suggested Teveten(R) had beneficial effects upon reducing urinary protein excretion, and therefore may be of benefit in preserving renal function in patients with progressive renal disease.

The presenters, Drs. Ritz, Sica, Weber, and Sever, noted that further research is necessary before a recommendation can be made for use of Teveten(R) in patients with severe renal impairment. The drug, which cleared the U.S. Food and Drug Administration in December of 1998, is currently indicated for the treatment of hypertension. It should be available to physicians now.