Efficacy of telmisartan for the treatment of persistent renal proteinuria in dogs: A double-masked, randomized clinical trial.

Abstract

BACKGROUND:

Information regarding efficacy of the angiotensin II receptor blocker, telmisartan, for treatment of proteinuria in dogs is limited.

OBJECTIVE:

To evaluate the antiproteinuric efficacy of telmisartan, as compared to enalapril, in dogs with chronic kidney disease and persistent, renal proteinuria.

ANIMALS:

Thirty-nine client-owned dogs with chronic kidney disease and urinary protein-to-creatinine ratio (UPC) > 0.5 (if azotemic) or ≥ 1.0 (if nonazotemic).

METHODS:

In this prospective, randomized, double-masked clinical trial, dogs were block randomized, according to presence or absence of azotemia and systemic arterial hypertension, to receive telmisartan (1.0 mg/kg PO q24h), or enalapril (0.5 mg/kg PO q12h), and followed for 120 days. Up-titration of study drug dosage on days 30 and 60, and addition of the other study drug at day 90, were performed if UPC > 0.5 was noted at these visits. Percentage change in UPC relative to baseline was calculated for all time points. Data are presented as median (range).

RESULTS:

Thirty-nine (20 telmisartan-treated, 19 enalapril-treated) dogs were included. At day 30, percentage change in UPC was greater for telmisartan-treated (-65% [-95% to 104%]) vs enalapril-treated (-35% [-74% to 87%]) dogs (P = .002). Among dogs persistently proteinuric at earlier visits, telmisartan remained superior to enalapril at days 60 (P = .02) and 90 (P = .02). No difference in percentage change in UPC between study groups was observed at day 120, when combination therapy was allowed. Combination therapy resulted in relevant azotemia in 4/13 (31%) dogs.

CONCLUSIONS AND CLINICAL IMPORTANCE:

Telmisartan might be a suitable first-line therapy for dogs with renal proteinuria.

• Authors: Bianca N Lourenço, Amanda E Coleman, Scott A Brown, Chad W Schmiedt, Max C Parkanzky, Kate E Creevy
• Journal: Journal of veterinary internal medicine (J Vet Intern Med) Vol. 34 Issue 6 Pg. 2478-2496 (Nov 2020) ISSN: 1939-1676 [Electronic] United States
• PMID: 33165969 (Publication Type: Journal Article, Randomized Controlled Trial, Veterinary)
• Copyright: © 2020 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Telmisartan

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Animals
• Dog Diseases (drug therapy)
• Dogs
• Prospective Studies
• Proteinuria (drug therapy, veterinary)
• Telmisartan (therapeutic use)
• Treatment Outcome