title: Effects of telmisartan therapy on interleukin-6 and tumor necrosis factor-alpha levels: a meta-analysis of randomized controlled trials.
abstract: A recent meta-analysis of randomized head-to-head trials suggests that therapy with telmisartan, an angiotensin II receptor blocker (ARB) and partial agonist of peroxisome proliferator-activated receptor-gamma, may increase adiponectin levels more strongly than other ARB therapies. Therefore, telmisartan would be expected to reduce interleukin-6 (IL-6) or tumor necrosis factor-alpha (TNF-α). To determine whether telmisartan reduces IL-6 or TNF-α, we performed the first meta-analysis of randomized controlled trials of telmisartan therapy. MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched through November 2011. Eligible studies were prospective randomized controlled trials of telmisartan vs. unrestricted control therapy reporting IL-6 or TNF-α levels as an outcome. For each study, data regarding percent changes from baseline to final IL-6 or TNF-α levels in both the telmisartan and control groups were used to generate standardized mean differences (SMDs) and 95% confidence intervals (CIs). Nine reports of randomized trials enrolling a total of 645 patients were identified. Pooled analysis of seven and five trials demonstrated a statistically significant reduction in percent changes of IL-6 (fixed-effects SMD, -0.385; 95% CI, -0.581 to -0.189; P<0.001; P for heterogeneity=0.073) and TNF-α levels (random-effects SMD, -0.627; 95% CI, -0.945 to -0.308; P<0.001; P for heterogeneity=0.029) with telmisartan relative to control therapy, respectively. In conclusion, based on a meta-analysis of nine randomized controlled trials, telmisartan therapy is likely effective in reducing IL-6 and TNF-α levels.
authors.affiliation: Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan. kfgth973@ybb.ne.jp
authors.forename: Hisato
authors.initials: H
authors.lastname: Takagi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Shin-nosuke
authors.initials: SN
authors.lastname: Goto
authors.forename: Takuya
authors.initials: T
authors.lastname: Umemoto
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016001:Confidence Intervals; D018592:Cross-Over Studies; D004311:Double-Blind Method; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000378:metabolism; D006977:Hypertension, Renal / Q000188:drug therapy; D007093:Imidazoles / Q000627:therapeutic use; D015850:Interleukin-6 / Q000097:blood*; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D011446:Prospective Studies; D017594:Publication Bias; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D000077333:Telmisartan; D013777:Tetrazoles / Q000627:therapeutic use; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*; D014633:Valine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000068756:Valsartan
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001562:Benzimidazoles; D001565:Benzoates; D002121:Calcium Channel Blockers; D007093:Imidazoles; D015850:Interleukin-6; D013777:Tetrazoles; D014409:Tumor Necrosis Factor-alpha; D017311:Amlodipine; D000068756:Valsartan; C437965:olmesartan; D014633:Valine; D000077333:Telmisartan