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Tel4.3
Telmisartan – Forschung
Überwiegend Mechanismus / Beobachtung
32 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Telmisartan sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2008–2026 mit einer typischen Studiengröße von 182 Teilnehmenden.
Basierend auf 32 Studien · 8 Meta-Analysen · 11 RCTs · 86,774 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Heart, blood pressure & strokeONTARGET zeigte, dass Telmisartan Ramipril bei Hochrisikopatienten hinsichtlich kardiovaskulärem Tod, Herzinfarkt, Schlaganfall und Herzinsuffizienz-bedingter Hospitalisierung nicht unterlegen war · Monate bis Jahre
Überwiegend Mechanismus / Beobachtung20 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung9 Studien
Glucose, insulin & metabolicÜber partiellen PPARγ-Agonismus verbessert es Insulinresistenz und Glukose stärker als andere ARBs (ein Surrogatmarker-Effekt) · Wochen bis Monate
Überwiegend Mechanismus / Beobachtung5 Studien
Cholesterol & lipidsONTARGET zeigte, dass Telmisartan Ramipril bei Hochrisikopatienten hinsichtlich kardiovaskulärem Tod, Herzinfarkt, Schlaganfall und Herzinsuffizienz-bedingter Hospitalisierung nicht unterlegen war · Monate bis Jahre
Überwiegend Mechanismus / Beobachtung3 Studien
Kidney & renal health
Überwiegend Mechanismus / Beobachtung3 Studien
Aging & healthspan (emerging)
Zu wenige bewertete Studien1 Studie
Aktives Forschungsgebiet
25 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2026
200820172026
1RCTn=1,670 · large study2026
The most common adverse event leading to discontinuation was an increase of 20% or more in the serum creatinine level.
Trident Research Group et al. · The New England journal of medicine (2026)
At a median follow-up of 2.5 years, recurrent stroke had occurred in 38 patients (4.6%) in the triple-pill group and 62 (7.4%) in the placebo group (hazard ratio, 0.61; 95% confidence interval [CI], 0.41 to 0.92; P = 0.02).
The incidence of major cardiovascular events was lower with the triple pill than with placebo (6.6% vs. 9.8%; P = 0.04).
Serious adverse events occurred in 23.2% of the patients in the triple-pill group and 26.0% of those in the placebo group.
Current evidence highlights ongoing uncertainty regarding the efficacy of medical therapies in reducing subthreshold AAA growth rates, rates of referral for surgical repair, or overall mortality.
Lu PYJ et al. · Interdisciplinary cardiovascular and thoracic surgery (2026)
However, propranolol (OR = 3.14, 95% CI, 1.34-7.35) and ticagrelor (OR = 5.10, 95% CI, 1.12-23.18) were associated with a higher rate of discontinuation due to adverse events.
Current evidence highlights ongoing uncertainty regarding the efficacy of medical therapies in reducing subthreshold AAA growth rates, rates of referral for surgical repair, or overall mortality.
The absence of statistically significant benefit may reflect underpowered datasets rather than definitive treatment inefficacy.
The certainty of evidence was low for migraine days, moderate for responder rates and high for headache days, with heterogeneity between studies categorized as 'might not be important' and no serious risk of bias.DiscussionThe systematic review and meta-analysis provide robust evidence on the effect of ARBs, particularly candesartan, in prevention of episodic migraine, supporting the rationale for reconsidering its position in international guidelines.Trial RegistrationProspero CRD42023405372.
Riise HS et al. · Cephalalgia : an international journal of headache (2026)
All four studies reported the outcomes migraine days and responder (≥50% reduction of migraine days) rates, and three reported headache days.
The combined effect size for migraine days and headache days were reductions of -1.00 (95% CI: -1.51 to -0.49, p<0.001), and -1.21 (95% CI: -1.62 to -0.81, p<0.001) days per month from baseline respectively.
The odds ratio for being a responder was 2.68 (95% CI: 1.91 to 3.78, p<0.001).
Larger and longer-term RCTs are warranted to confirm.
Shubietah A, Elgendy MS, Emara A, Abdul-Hafez HA, Awashra A, Elbably I, Abuelazm M, Mhanna M. · High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension (2026)
Random-effects model to pool mean difference (MD) for continuous outcomes and risk ratios (RR) for binary outcomes with 95% confidence intervals (CI).
Compared with control, low-dose GMRx2 significantly reduced office systolic BP at 4-6 weeks (MD -8.84 mmHg, 95% CI [-11.27; -6.46]) and 12 weeks (MD -5.52 mmHg, 95% CI [-6.85; -4.18]).
It also increased the proportion of patients achieving target office BP at 4-6 weeks (66.7% vs. 50.2%, RR 1.20, 95% CI [1.08-1.43]) and 8-12 weeks (75.6% vs. 59.5%, RR 1.15, 95% CI [1.05-1.26]).
Telmisartan was non-inferior to ramipril for major cardiovascular events, but the combination of the two increased adverse events without added benefit.
ONTARGET Investigators, Yusuf, Teo, Pogue, Dyal, Copland · The New England journal of medicine (2008)
ONTARGET randomized 25,620 high-vascular-risk patients to ramipril, telmisartan, or both
Telmisartan was non-inferior (not superior) to the ACE inhibitor ramipril for the composite of CV death, MI, stroke, or HF hospitalization
Counter-evidence: the combination arm caused more hypotension, syncope, and renal dysfunction without added benefit
T20/SA2.5 demonstrated superior BP-lowering efficacy and favorable tolerability compared with T40 in patients inadequately controlled on T20, supporting the value of early low-dose combination therapy.
Youn JC et al. · Drug design, development and therapy (2026)
At week 8, least squares (LS) mean (standard error [SE]) reduction in MSSBP from baseline was greater with T20/SA2.5 than with T40 (-16.97 [2.06] mmHg vs. -7.42 [2.04] mmHg; P<0.001).
LS mean (SE) reductions in MSDBP at week 8 were also greater with T20/SA2.5 than with T40 (-7.98 [1.17] mmHg vs. -4.01 [1.15] mmHg; P=0.006).
The BP control rate was significantly higher with T20/SA2.5 than with T40 (53.70% vs. 29.63%; P=0.010); the response rate was numerically higher with T20/SA2.5 (12.96% vs. 5.56%; P=0.182).
Clinical trial registration This study was registered in ClinicalTrials.gov (NCT06121518).
Lee SH, Park K, Lee KH, Cho Y, Kim DH, Lim S, Bo Yoon S, Jang JS, Lim HS, Doh JH, Kim DY, Sohn IS, Cheon DY, Bae MH, Kim SH, Lee Y, Ihm SH, Choi RK, Park HJ, Pyun WB, Choi S, Shin J. · Clinical therapeutics (2026)
There were no statistically significant differences in the incidence of overall AEs and adverse drug reactions among the 3 groups, and no serious adverse events occurred during the study.
Similarly, the Tel/S-Amlo group showed a change of -21.12 (1.33) mm Hg versus -15.58 (1.32) mm Hg in the S-Amlo group (between-group difference -5.53 (1.61) mm Hg, P-value = 0.0008).
Implications Combination therapy with a low-dose of telmisartan and s-amlodipine may be a promising initial treatment for patients with hypertension.
Future large-scale, randomized, comparative outcome trials are needed to better define the relative clinical benefits of this combination.
Hiremath J, Kirpalani A, Chafekar D, Jayagopal PB, Ray S, Chopra VK, Dani S, Tripathi K, Sawhney JPS, Oomman A, Sathe S, Abdullakutty J, Kher V, Dewan D, Sharma K, Shete M, Vali PS, Jain S, Swami OC. · Cureus (2026)
Non-pharmacological interventions such as dietary modification, physical activity, smoking cessation, stress management, and adherence to therapy through fixed-dose combinations were also endorsed.
This expert consensus supports a comprehensive, patient-centered approach to hypertension management in India.
Available evidence suggests that cilnidipine and telmisartan may offer potential benefits beyond BP reduction, largely based on pharmacologic properties and surrogate outcomes.
Eden NE, Zamir A, Saeed H, Alqahtani F, Rasool MF. · Expert review of clinical pharmacology (2025)
The findings from T2DM patients with moderate renal impairment displayed a 27% increase in AUC 0-∞ of canagliflozin.
Furthermore, co-administration of CFZ with rifampin in humans reduced Cmax by 28%, while with telmisartan in rats, CL/F decreased 31.1% initially, but increased 62.9% after 7 days.
Expert opinion This review integrates all significant human PK parameters of CFZ by combining findings from existing studies, allowing researchers to develop and evaluate PK models for recommending model-based dose optimization.
However, there is no significant difference regarding adverse events between both arms.
Habboush S, Kagita NV, Gadelmawla AF, Elmoursi A, Merza N, Abdo AA, Zahran AHM, Eldeib M, Almarghany AA, Abdelfadil MM, Abdelkarim MA, Shawky I, Mohammed OM, Alharran A, Ali MM, Elbardisy S. · High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension (2025)
Results Our analysis showed TAR [n = 155] significantly reduced mean systolic blood pressure (MSSBP) at week 4 compared to TR (n = 163) (MD = -15.65 mmHg) and TA (MD = -4.63 mmHg).
TAR also showed superiority over all groups (TR [n = 163], TA [n = 162]) in MSSBP reduction.
For low-density lipoprotein-cholesterol (LDL-C), TAR only showed a significant difference at week 4 compared to TA (MD = -86.41 mg/dL), with no difference between TAR and TR at either week 4 or 8.
This review underscores the potential of telmisartan as a valuable therapeutic option for CNS disorders, warranting continued exploration to optimize its clinical application.
Quan W, Zhang SX, Zhang XY, Chen X, Yang C, Li ZY, Hu R. · Pharmacological reports : PR (2025)
We summarize telmisartan's efficacy in addressing a range of neurological conditions, such as stroke, traumatic brain injury, dementia, Parkinson's disease, demyelinating diseases, psychiatric disorders, and gliomas.
By targeting multiple pathways involved in these disorders, telmisartan demonstrates potential as both an adjunctive and standalone therapy.
Its ability to attenuate neuroinflammation and promote cellular repair highlights its versatility in CNS disease management.
Conclusion These findings quantified the variability of telmisartan PK profile and highlighted the differences between healthy individuals and hypertensive patients, suggesting the need for optimized dosage strategies to improve therapeutic outcomes.
Jeong IH, Ryu S, Han N, Staatz CE, Baek IH. · Clinical pharmacokinetics (2025)
Interindividual variabilities in CL/F, V 1 /F, and k a were 84%, 122%, and 106%, respectively.
Covariate analysis revealed significantly lower CL/F (63.7%) and V 1 /F (90.3%) values in hypertensive patients than healthy subjects.
Typical PK parameter values for apparent clearance (CL/F), apparent central and peripheral volumes of distribution (V 1 /F and V 2 /F), absorption rate constant (k a ), and absorption lag time were 18.3 L/h, 20.7 L, 360 L, 0.183 h -1 and 0.228 h, respectively.
In ACE-inhibitor-intolerant patients, telmisartan was well tolerated but had only a modest, non-significant effect on the primary cardiovascular composite.
Low-dose triple single-pill combination of telmisartan/amlodipine/chlorthalidone demonstrated superior BP-lowering efficacy with well-tolerated and comparable safety to standard-dose telmisartan monotherapy.
At week 8, the combination group demonstrated significant mean sitting systolic blood pressure reduction compared with monotherapy in the per-protocol set analysis (least squares mean difference, -3.8 mm Hg [95% CI: -6.7 to -0.9]; P=0.01), establishing its noninferiority.
Furthermore, the superiority of the combination therapy was confirmed in the full analysis set (LS mean difference, -4.0 mm Hg [95% CI, -6.8 to -1.3]; P<0.01).
Mean sitting diastolic BP, BP normalization rates, and response rates also favored the combination group at weeks 4 and 8 (all P<0.01).
Ahn HS et al. · Journal of clinical hypertension (Greenwich, Conn.) (2026)
At week 8, TEL/AML 20/2.5 showed significantly greater MSSBP reductions compared with TEL 20 [least squares mean (LSM) differences: -5.79 mmHg; p = 0.0003] and AML 2.5 (-8.57 mmHg; p < 0.0001).
Non-inferiority to TEL 40 was established, with an LSM difference of -3.88 mmHg (95% Confidence Interval: -6.67 to -1.09), which met the pre-specified 3 mmHg margin.
The overall incidence of adverse events was 8.05%, with no statistically significant differences between groups.