Combination treatment with Tekturna/Rasilez (Novartis) raises risk for patients with Hypertension

Following the closure of the Phase III ALTITUDE trial, researchers have published the first detailed figures showing the risk of using Tekturna/Rasilez, from Novartis, in combination with angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARB) drugs. After reviewing 10 large trials, researchers found that patients taking Tekturna/Rasilez as well as an ACE inhibitor or ARB had about a 50 per cent greater risk of developing hyperkalemia � high levels of potassium in the blood � than those taking only an ACE inhibitor or ARB. In addition, patients taking a combination of Tekturna/Rasilez plus an ACE inhibitor or ARB had a 70 per cent greater risk of developing hyperkalemia than those taking Tekturna/Rasilez alone. Hyperkalemia can lead to an irregular heartbeat or increased risk of cardiac arrest. Previous research in 2008 found an increased risk of hyperkalemia and acute kidney failure in people taking a combination of ACE inhibitors and ARBs. Lead researcher on the latest trial, Dr. Ziv Harel at St Michael's Hospital in Toronto, Canada, was surprised to find no increased risk of kidney failure in patients taking Rasilez and an ACE inhibitor or ARB over those taking just one of the drugs. see "The effect of combination treatment with aliskiren and blockers of the renin-angiotensin system on hyperkalaemia and acute kidney injury: systematic review and meta-analysis" BMJ2012;344doi: 10.1136/bmj.e42(Published 9 January 2012)Cite this as:BMJ2012;344:e42 Ziv Harel, et al.,