Efficacy of long-term oral telmisartan treatment in cats with hypertension: Results of a prospective European clinical trial

BACKGROUND: Efficacy of telmisartan in treating hypertension (HT) in cats has not been largely investigated. OBJECTIVE: Telmisartan oral solution effectively controls systolic arterial blood pressure (SABP) in hypertensive cats. ANIMALS: Two-hundred eighty-five client-owned cats with systemic HT. METHODS: Prospective, multicenter, placebo-controlled, randomized, double-blinded study. Hypertensive cats diagnosed with SABP ≥160 mmHg and ≤200 mmHg without target-organ-damage were randomized (2 : 1 ratio) to receive 2 mg/kg telmisartan or placebo q24 PO. A 28-day efficacy phase was followed by a 120-day extended use phase. Efficacy was defined as significant difference in mean SABP reduction between telmisartan and placebo on Day 14 and group mean reduction in SABP of > 20 mmHg by telmisartan on Day 28 compared to baseline. RESULTS: Two-hundred fifty-two cats completed the efficacy and 144 cats the extended use phases. Mean SABP reduction at Day 14 differed significantly between groups (P < .001). Telmisartan reduced baseline SABP of 179 mmHg by 19.2 (95% confidence interval [CI]: 15.92-22.52) and 24.6 (95% CI: 21.11-28.14) mmHg at Days 14 and 28. The placebo group baseline SABP of 177 mmHg was reduced by 9.0 (95% CI: 5.30-12.80) and 11.4 (95% CI: 7.94-14.95) mmHg, respectively. Of note, 52% of telmisartan-treated cats had SABP <150 mmHg at Day 28. Mean SABP reduction by telmisartan in severe (≥180 mmHg) and moderate HT (160-179 mmHg) was comparable and persistent over time. CONCLUSIONS AND CLINICAL IMPORTANCE: Telmisartan solution (PO) was effective in reducing SABP in hypertensive cats with SABP ≥160 mmHg and ≤200 mmHg

Comparison of Efficacy of Long-term Oral Treatment with Telmisartan and Benazepril in Cats with Chronic Kidney Disease

Background: The efficacy and benefits of telmisartan in cats with chronic kidney disease (CKD) have not previously been reported. Hypothesis: Long-term treatment of cats with CKD using telmisartan decreases urine protein-to-creatinine ratio (UP/C) similar to benazepril. Animals: Two-hundred and twenty-four client-owned adult cats with CKD. Methods: Prospective, multicenter, controlled, randomized, parallel group, blinded clinical trial with noninferiority design. Cats were allocated in a 1 : 1 ratio to either telmisartan (1 mg/kg; n = 112) or benazepril (0.5-1.0 mg/kg; n = 112) PO q24 h. The primary endpoint was prospectively defined as the change in proteinuria (benazepril:telmisartan) based on a log transformed weighted average of UP/C change from baseline (AUC 0?t/t) as a percentage compared using a confidence interval (CI) approach. Changes of UP/C from baseline were assessed on all study days and corrected for multiple comparisons. Results: Telmisartan proved noninferior to benazepril in controlling proteinuria (CI, À0.035 to 0.268). At Day 180, UP/C compared to baseline in the telmisartan group was significantly lower (À0.05 AE 0.31; P = .016), whereas in the benazepril group the change (À0.02 AE 0.48) was not statistically significant (P = .136). Similar results were obtained at all assessment points with significant decrease in UP/C occurring with telmisartan but not benazepril. Conclusion and Clinical Importance: Both telmisartan and benazepril were well tolerated and safe. Telmisartan proved to be noninferior to benazepril and significantly decreased proteinuria relative to baseline at all assessment points whereas benazepril did not