Azilsartan medoxomil is an orally active pro-drug. It is rapidly converted to the active moiety, azilsartan, which selectively antagonises the effects of angiotensin II by blocking its binding to the AT1 receptor.1
In a 6-week randomised, double-blind, placebo-controlled trial, azilsartan medoxomil (40mg and 80mg) was compared with valsartan 320mg and olmesartan medoxomil 40mg in 1291 patients. Change from baseline in placebo-adjusted 24-hour mean systolic BP was significantly greater with azilsartan medoxomil 80mg (-14.3mmHg) than olmesartan medoxomil (-11.7mmHg; p=0.009) or valsartan (-10.0mmHg; p<0.001), and the 40mg dose of azilsartan medoxomil was non-inferior to olmesartan (difference -1.4mmHg [95% CI: -3.3 to 0.5]).2
A second 6-week study of similar design involved 1275 patients; 142 received placebo and the remainder received azilsartan medoxomil 20mg, 40mg or 80mg or olmesartan medoxomil 40mg. In this study, the reduction in 24-hour mean systolic BP was 2.1mmHg greater with azilsartan medoxomil 80mg than olmesartan medoxomil 40mg (95% CI -4.0 to -1.0; p=0.038), and azilsartan medoxomil 40mg was non-inferior to olmesartan medoxomil.3
1. Edarbi Summary of Product Characteristics, December 2011.
2. White WB et al. Hypertension 2011; 57: 413-20.
3. Bakris GL et al. J Clin Hypertens 2011; 12: 81-88.
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Further information: Takeda UK Ltd