Related trials
		 
			
				 
				
					ACCOMPLISH (diabetic subgroup), 2010 - benazepril + amlodipine  vs benazepril + hydrochlorothiazide
				
			 
			
				 
				
					ACCORD blood pressure, 2010 - more intensive blood pressure lowering strategie  vs less intensive blood pressure lowering strategie
				
			 
			
				 
				
					ROADMAP, 2010 - olmesartan  vs placebo
				
			 
			
				 
				
					AVOID, 2008 - aliskiren  vs placebo
				
			 
			
				 
				
					ADVANCE, 2007 - perindopril and indapamide  vs placebo
				
			 
			
				 
				
					ABCD (N), 2002 - more intensive blood pressure lowering strategie  vs less intensive blood pressure lowering strategie
				
			 
			
				 
				
					ALLHAT (lisi vs chlor, diabetic subgroup), 2002 - lisinopril  vs chlorthalidone
				
			 
			
				 
				
					LIFE (diabetic subgroup), 2002 - losartan  vs atenolol
				
			 
			
				 
				
					ALLHAT (amlodipine vs chlor, diabetic subgroup), 2002 - amlodipine  vs chlorthalidone
				
			 
			
				 
				
					IPDM, 2001 - irbesartan  vs placebo
				
			 
			
				 
				
					IDNT amlodipine, 2001 - amlodipine  vs placebo
				
			 
			
				 
				
					RENAAL, 2001 - losartan  vs placebo
				
			 
			
				 
				
					IDNT irbesartan, 2001 - Irbesartan  vs placebo
				
			 
			
				 
				
					IDNT (irbesartan vs amlodipine), 2001 - Irbesartan  vs amlodipine
				
			 
			
				 
				
					STOP-2  CCB (diabetic subgroup), 2000 - calcium-channel blocker  vs diuretic or beta-blocker
				
			 
			
				 
				
					INSIGHT (diabetic subgroup), 2000 - Nifedipine  vs coamilozide
				
			 
			
				 
				
					ABCD (H), 2000 - more intensive blood pressure lowering strategie  vs less intensive blood pressure lowering strategie
				
			 
			
				 
				
					NORDIL (diabetic subgroup), 2000 - Diltiazem  vs diuretic or beta-blocker
				
			 
			
				 
				
					STOP-2 (ACEI vs CCB) (diabetic subgroup), 2000 - ACE inhibitor  vs CCB
				
			 
			
				 
				
					HOPE (diabetic subgroup), 2000 - ACE inhibitor  vs placebo
				
			 
			
				 
				
					STOP-2 ACEI (diabetic subgroup), 2000 - ACE inhibitor  vs diuretic or beta-blocker
				
			 
			
				 
				
					CAPP (diabetic subgroup), 1999 - captopril  vs diuretic or beta-blocker
				
			 
			
				 
				
					Syst-Eur (diabetic subgroup), 1999 - nitrendipine  vs placebo
				
			 
			
				 
				
					ABCD, 1998 - nisoldipine  vs enalapril
				
			 
			
				 
				
					UKPDS 38, 1998 - captopril or atenolol  vs control
				
			 
		 
		 
		 
		
		See also:
		 
			
				
					All diabetes clinical trials
				
			
			
				
					All hypertension clinical trials
				
			
		
			
			All clinical trials of anti hypertensive agent 
			
		
		
			
			All clinical trials of Irbesartan 
			
		
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	Treatments
	
	
		| Studied treatment | 
		
		Irbesartan 300 mg daily
		 
		
		
		 | 
	 
	
		| Control treatment | 
		
		placebo
		 
		
		
		 | 
	 
	 
	
	
	
	Patients
	
		
			| Patients | 
			hypertensive patients with nephropathy due to type 2 diabetes 
  | 
		 
		
			| Inclusion criteria | 
			age between 30 and 70 years; documented diagnosis of type 2 diabetes mellitus, hypertension (systolic blood pressure of more than 135 mm Hg while sitting, diastolic blood pressure of more than 85 mm Hg while sitting, or documented treatment with antihypertensive agents); proteinuria, with urinary protein excretion of at least 900 mg per 24 hours.  Serum creatinine concentration between 1.0 and 3.0 mg per deciliter (88 and 265 ìmol per liter) in women and 1.2 and 3.0 mg per deciliter (106 and 265 ìmol per liter) in men 
 | 
		 
				| Baseline characteristics | 
					
					
						
							| Glycosylated hemoglobin | 
							8.2%  | 
						 
						
							| BP (systolic/diastolic) | 
							158/87  | 
						 
						
							| Female (%) | 
							31%  | 
						 
						
							| Age | 
							59 y  | 
						 
						
							| subgroup | 
							no  | 
						 
						
							| hypertension (%) | 
							100%  | 
						 
					 						
					 | 
				 
	 
	
	
	
	
	
	
	Method and design
	
	
		| Randomized effectives | 
		579 / 569 (studied vs. control) | 
	 
		
			| Design | 
			Parallel groups | 
		 
		
			| Blinding | 
			double blind | 
		 
		
			| Follow-up duration | 
			2.6 years | 
		 
		
			| Number of centre | 
			210 | 
		 
		
			| Geographic area | 
			Worldwide | 
		 
		
			| Hypothesis | 
			Superiority | 
		 
		
			| Primary endpoint | 
			renal death | 
		 
		
			| Remarks | 
							 
				 | 
		 
	
	 
	
	
	
	
	
	
	
  
	Results	
	
	
	
		
	
	
		
			Endpoint
		
	
	
		
		Studied treat. n/N
			
	
	
		
		Control treat. n/N
		
	
	
		
			Graph
		
	
	
		
			RR [95% CI]
		
	
	
		
			
				
				renal death 
				 
			
		
			
				
				189 / 579 
				
			
			
				
				222 / 569 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,84 [0,72;0,98]
				
			
	
	
		
			
				
				cardiovascular event (fatal and non fatal) 
				 
			
		
			
				
				NA / 579 
				
			
			
				
				NA / 569 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,91 [0,72;1,15]
				
			
	
	
		
			
				
				All cause death
				 
			
		
			
				
				NA / 579 
				
			
			
				
				NA / 569 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,92 [0,69;1,23]
				
			
	
	
		
			
				
				microvascular events 
				 
			
		
			
				
				NA / 579 
				
			
			
				
				NA / 569 
				
			
		
			
				
					
					
					
					
				
			
				
				
			
			
		
			
				
					0,80 [0,66;0,97]
				
			
	
	
		
		
		
		
		
			
				0
			
		
		
		
		
		
				2
		
		
		
		
		
			1.0
		
	
  
 
	 
		
	
		
		
				
					| 
						Relative risks
					 | 
				 
			
			| Endpoint | 
			Events (%) | 
			Relative Risk | 
			95% CI | 
			Endpoint definition in the trial | 
			Ref | 
			 
			
			| Studied treat. | 
			Control treat. | 
			 
					
					
						| 
							renal death 
						 | 
						189 / 579 (32,6%) | 
						222 / 569 (39,0%) | 
						0,84 | 
						[0,72;0,98] | 
						  | 
						12500  | 
					 
					
					
					
					
					
					
					
					
		
			| 
			The primary endpoint (if exists) appears in blod characters
			 | 
		 
		
			| 
			Reference(s) used for data extraction: 
				
					12500: Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz IRenoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes.N Engl J Med 2001;345:851-60
				
			 | 
		 
		 
		
		
			
			| Endpoint | 
			studied treat. | 
			control treat. | 
			mean diff | 
			 
		 
	 
	
	
	
				
					| 
						Absolute risk reduction 
					 | 
				 
	
		| Endpoint | 
		Events rate | 
		Absolute risk reduction (ARR) | 
	 
	
		| Studied treat. | 
		Control treat. | 
	 
			
				| renal death  | 
				32,64% | 
				39,02% | 
				
					-63,7‰
				 | 
			 
	 	
	 
Meta-analysis of all similar trials: 
			
				
					angiotensin renin system blockade in diabetes for all type of patients
				
			 
			
				
					anti hypertensive agent in diabetes for type1 and 2 diabetic patients with hypertension
				
			 
			
				
					anti hypertensive agent in hypertension for diabetic patients 
				
			 
	
  
	
	
	
	
	
	
	
	
	
	
	
		 
		Reference(s)
	
	
	
			- 
				
			    Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA, Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I. 
			    Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes..
			    N Engl J Med 2001;345:851-60
			    
 
				
					 
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