Patients see greater BP drop with combination therapy at the start

A combination drug therapy given initially appears to result in better blood pressure (BP) control in individuals compared with those who are treated with monotherapy, according to research published online January 13 in The Lancet, HealthDay News reported. Those who underwent the 2-drug treatment after taking the single-drug therapy also experienced better blood pressure outcomes, though not at the same level as those who began with the combination treatment.

In a 32-week trial, Morris J. Brown, MD, FRCP, of the University of Cambridge (United Kingdom) and colleagues found that patients on a combination therapy of aliskiren (Tekturna, Novartis Pharmaceuticals) and amlodipine (Norvasc, Pfizer) had a greater reduction in mean systolic BP than those on either drug alone by 6.5 mm Hg (P<.0001). By week 24, when all patients were receiving combination therapy, the difference between groups had fallen to 1.4 mm Hg (P=.059).

“Our findings show that patients randomly assigned to initial combination treatment with both aliskiren and amlodipine had substantially better mean blood pressure reduction over the first 24 weeks than patients starting on either drug as monotherapy, with no cost in adverse events or withdrawals,” the authors wrote. “Once the monotherapy patients progressed to combination therapy, their blood pressure fell toward, but never numerically caught up with, that of the initial combination group.”

Novartis Pharma AG funded the trial, and several authors disclosed financial relationships with the company.