The IDEAL Study : Towards Personalized Drug Treatment of Hypertension
Identifieur interne : 001664 ( Istex/Curation ); précédent : 001663; suivant : 001665The IDEAL Study : Towards Personalized Drug Treatment of Hypertension
Auteurs : Theodora Bejan-Angoulvant [France] ; Jean-Philippe Baguet [France] ; Sylvie Erpeldinger [France] ; Jean-Marc Boivin [France] ; Alain Mercier [France] ; Georges Leftheriotis [France] ; Jean-Pierre Gagnol [France] ; Jean-Pierre Fauvel [France] ; Céline Giraud [France] ; Giampiero Bricca [France] ; François Gueyffier [France]Source :
- Thérapie [ 0040-5957 ] ; 2012-08-09.
Abstract
Objective. To identify markers (phenotypic, genetic, or environmental) of blood pressure (BP) response profiles to angiotensin converting enzyme inhibitors (ACEIs) and diuretics. Methods. IDEAL was a crossover (two active and two wash out phases), double-blind, placebo-controlled trial. Eligible patients were untreated hypertensive, aged 25 to 70. After two visits, patients were randomized to one of four sequences. The main outcome was BP differences between the active treatment and placebo. Results. One hundred and twenty-four patients were randomised: mean age 53, men 65%, family history of hypertension 60%. Average BP fall at each visit before randomisation was about 2% of the initial level reflecting both a regression to the mean and a placebo effect. Conclusion. The results are expected to improve knowledge in drug’s mechanisms of action and pathophysiology of hypertension, and to help in personalizing treatment. The estimation of BP responses to each drug in standardized conditions provided a benefit to each participant.
Objectif. Identifier les marqueurs (phénotypiques, génétiques, environnementaux) des profils de réponse pressionnelle à un inhibiteur de l’enzyme de conversion de l’angiotensine et un diurétique. Méthodes. IDEAL est un essai en plan croisé (2 phases actives et 2 phases de désimprégnation) en double-insu versus placebo. Les patients étaient des hypertendus non traités de 25 à 70 ans. Deux visites précédaient la randomisation des patients. Le critère principal était la différence de PA traitement actif versus placebo. Résultats. Cent vingt-quatre patients ont été randomisés d’âge moyen 53, hommes 65 %, histoire familiale d’hypertension 60 %. La baisse moyenne de PA à chaque visite pré-randomisation était d’environ 2 % du niveau initial traduisant une régression vers la moyenne et un effet placebo. Conclusion. IDEAL permettra d’améliorer les connaissances sur les mécanismes d’action des médicaments dans l’hypertension, étape indispensable vers la personnalisation du traitement. L’estimation de la réponse pressionnelle dans des conditions standardisées a représenté un bénéfice réel pour chaque participant.
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DOI: 10.2515/therapie/2012031
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Hypertension</title><author><name sortKey="Bejan Angoulvant, Theodora" sort="Bejan Angoulvant, Theodora" uniqKey="Bejan Angoulvant T" first="Theodora" last="Bejan-Angoulvant">Theodora Bejan-Angoulvant</name><affiliation wicri:level="1"><mods:affiliation>Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France; UMR 5558, CNRS, Villeurbanne, France; Claude Bernard Lyon 1 University, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France; UMR 5558, CNRS, Villeurbanne, France; Claude Bernard Lyon 1 University, Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Baguet, Jean Philippe" sort="Baguet, Jean Philippe" uniqKey="Baguet J" first="Jean-Philippe" last="Baguet">Jean-Philippe Baguet</name><affiliation wicri:level="1"><mods:affiliation>Department of Cardiology, Centre Hospitalier Universitaire, Grenoble, France; INSERM 1039, Bioclinic Radiopharmaceutics Laboratory, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Cardiology, Centre Hospitalier Universitaire, Grenoble, France; INSERM 1039, Bioclinic Radiopharmaceutics Laboratory, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Erpeldinger, Sylvie" sort="Erpeldinger, Sylvie" uniqKey="Erpeldinger S" first="Sylvie" last="Erpeldinger">Sylvie Erpeldinger</name><affiliation wicri:level="1"><mods:affiliation>Department of General Practice, Claude Bernard Lyon 1 University, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Claude Bernard Lyon 1 University, Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Boivin, Jean Marc" sort="Boivin, Jean Marc" uniqKey="Boivin J" first="Jean-Marc" last="Boivin">Jean-Marc Boivin</name><affiliation wicri:level="1"><mods:affiliation>Plurithematic Clinical Investigation Centre, CIC-P-Inserm CHU de Nancy, Lorraine Institute of Heart and Vessels Louis Mathieu, Vandœuvre-lès-Nancy, France; Henri Poincaré Nancy University, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Plurithematic Clinical Investigation Centre, CIC-P-Inserm CHU de Nancy, Lorraine Institute of Heart and Vessels Louis Mathieu, Vandœuvre-lès-Nancy, France; Henri Poincaré Nancy University</wicri:regionArea></affiliation></author><author><name sortKey="Mercier, Alain" sort="Mercier, Alain" uniqKey="Mercier A" first="Alain" last="Mercier">Alain Mercier</name><affiliation wicri:level="1"><mods:affiliation>Department of General Practice, Faculty of Medicine, Rouen University, Rouen, France; CIC Inserm 0204, CHU of Rouen, Rouen, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of General Practice, Faculty of Medicine, Rouen University, Rouen, France; CIC Inserm 0204, CHU of Rouen, Rouen</wicri:regionArea></affiliation></author><author><name sortKey="Leftheriotis, Georges" sort="Leftheriotis, Georges" uniqKey="Leftheriotis G" first="Georges" last="Leftheriotis">Georges Leftheriotis</name><affiliation wicri:level="1"><mods:affiliation>Vascular Functionnal Exploration Laboratory, CHU Angers, Angers, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Vascular Functionnal Exploration Laboratory, CHU Angers, Angers</wicri:regionArea></affiliation></author><author><name sortKey="Gagnol, Jean Pierre" sort="Gagnol, Jean Pierre" uniqKey="Gagnol J" first="Jean-Pierre" last="Gagnol">Jean-Pierre Gagnol</name><affiliation wicri:level="1"><mods:affiliation>Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Arnaud de Villeneuve Hospital, CHU Montpellier, Montpellier</wicri:regionArea></affiliation></author><author><name sortKey="Fauvel, Jean Pierre" sort="Fauvel, Jean Pierre" uniqKey="Fauvel J" first="Jean-Pierre" last="Fauvel">Jean-Pierre Fauvel</name><affiliation wicri:level="1"><mods:affiliation>Department of Nephrology and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Nephrology and Hypertension, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Giraud, Celine" sort="Giraud, Celine" uniqKey="Giraud C" first="Céline" last="Giraud">Céline Giraud</name><affiliation wicri:level="1"><mods:affiliation>Clinical Investigation Center, CIC 201, INSERM, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Clinical Investigation Center, CIC 201, INSERM, Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Bricca, Giampiero" sort="Bricca, Giampiero" uniqKey="Bricca G" first="Giampiero" last="Bricca">Giampiero Bricca</name><affiliation wicri:level="1"><mods:affiliation>Endocrine and Metabolic Function Exploration, Centre of Biology North, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Endocrine and Metabolic Function Exploration, Centre of Biology North, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon</wicri:regionArea></affiliation></author><author><name sortKey="Gueyffier, Francois" sort="Gueyffier, Francois" uniqKey="Gueyffier F" first="François" last="Gueyffier">François Gueyffier</name><affiliation wicri:level="1"><mods:affiliation>Clinical Investigation Centre, CIC 201 Inserm and Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France; UMR 5558, CNRS, Villeurbanne, France; Claude Bernard Lyon 1 University, Lyon, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Clinical Investigation Centre, CIC 201 Inserm and Department of Clinical Pharmacology, Hospices Civils de Lyon, Lyon, France; UMR 5558, CNRS, Villeurbanne, France; Claude Bernard Lyon 1 University, Lyon</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Thérapie</title><title level="j" type="abbrev">Therapie</title><title level="j" type="publisher-id">therapie</title><idno type="ISSN">0040-5957</idno><idno type="eISSN">1958-5578</idno><imprint><publisher>EDP Sciences</publisher><date type="Final-Published" when="2012-08-09">2012-08-09</date><date type="ePublished" when="2012-08-09">2012-08-09</date><date type="Published" when="2012-05">2012-05</date><biblScope unit="vol">67</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="195">195</biblScope><biblScope unit="page" to="204">204</biblScope><biblScope unit="page-count">10</biblScope><biblScope unit="ref-count">43</biblScope></imprint><idno type="ISSN">0040-5957</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0040-5957</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. To identify markers (phenotypic, genetic, or environmental) of blood pressure (BP) response profiles to angiotensin converting enzyme inhibitors (ACEIs) and diuretics. Methods. IDEAL was a crossover (two active and two wash out phases), double-blind, placebo-controlled trial. Eligible patients were untreated hypertensive, aged 25 to 70. After two visits, patients were randomized to one of four sequences. The main outcome was BP differences between the active treatment and placebo. Results. One hundred and twenty-four patients were randomised: mean age 53, men 65%, family history of hypertension 60%. Average BP fall at each visit before randomisation was about 2% of the initial level reflecting both a regression to the mean and a placebo effect. Conclusion. The results are expected to improve knowledge in drug’s mechanisms of action and pathophysiology of hypertension, and to help in personalizing treatment. The estimation of BP responses to each drug in standardized conditions provided a benefit to each participant.</div><div type="abstract" xml:lang="fr">Objectif. Identifier les marqueurs (phénotypiques, génétiques, environnementaux) des profils de réponse pressionnelle à un inhibiteur de l’enzyme de conversion de l’angiotensine et un diurétique. Méthodes. IDEAL est un essai en plan croisé (2 phases actives et 2 phases de désimprégnation) en double-insu versus placebo. Les patients étaient des hypertendus non traités de 25 à 70 ans. Deux visites précédaient la randomisation des patients. Le critère principal était la différence de PA traitement actif versus placebo. Résultats. Cent vingt-quatre patients ont été randomisés d’âge moyen 53, hommes 65 %, histoire familiale d’hypertension 60 %. La baisse moyenne de PA à chaque visite pré-randomisation était d’environ 2 % du niveau initial traduisant une régression vers la moyenne et un effet placebo. Conclusion. IDEAL permettra d’améliorer les connaissances sur les mécanismes d’action des médicaments dans l’hypertension, étape indispensable vers la personnalisation du traitement. L’estimation de la réponse pressionnelle dans des conditions standardisées a représenté un bénéfice réel pour chaque participant.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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