Azilsartan Medoxomil (Edarbi): The Eighth Angiotensin II Receptor Blocker.

Abstract

Hypertension affects approximately one in three adults in the U.S. and is a major risk factor for cardiovascular disease. Each year, hypertension contributes to one of every seven deaths in the U.S. and to nearly half of all cardiovascular disease-related deaths, including stroke.1 If all hypertensive patients were treated effectively to reach the blood pressure (BP) goals established in current clinical guidelines, 46,000 deaths might be averted each year.2 In addition to the cost in lives lost, hypertension is costly to the health care system in terms of dollars spent. The American Heart Association recently estimated that the direct and indirect costs of hypertension total more than $93.5 billion per year and that cardiovascular disease and stroke account for 17% of total annual health expenditures in the U.S.3 Eight classes of medications are currently used in the treatment of hypertension. They include diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), beta-adrenergic blockers, alpha-adrenergic blockers, calcium-channel blockers (CCBs), central alpha-adrenergic receptor agonists (also called central adrenergic inhibitors), and direct renin inhibitors (DRIs). Until recently, the ARB class consisted of seven agents: candesartan (Atacand, AstraZeneca), eprosartan (Teveten, Abbott), irbesartan (Avapro, Bristol-Myers Squibb/Sanofi), losartan (Cozaar, Merck), olmesartan (Benicar, Daiichi Sankyo), telmisartan (Micardis, Boehringer Ingelheim), and valsartan (Diovan, Novartis). Many of these drugs are available in combination with other antihypertensive agents, such as the DRI aliskiren (Tekturna, Novartis), the CCB amlodipine (Nor vasc, Pfizer), and the thiazide diuretic hydrochlorothiazide (HCTZ). Four ARBs have been approved for indications other than hypertension. Candesartan and valsartan may be used for the treatment of heart failure,4,5 and irbesartan and losartan are indicated for the treatment of nephropathy in patients with type-2 diabetes and hypertension.6,7 Azilsartan medoxomil (Edarbi, Takeda) is a new addition to the ARB class of antihypertensive agents. It received FDA approval in February 2011.8