Transcript MARVAL Study

‫חזק בהגנה כלייתית‬
‫לדיובן הגנה כלייתית מוכחת‬
‫בחולי סכרת מסוג ‪,2‬‬
‫(היפרטנסיבים ונורמוטנסיבים)‬
‫עם מיקרואלבומינוריה‬
MARVAL: MicroAlbuminuria
Reduction With Valsartan
Objective:
To assess the effects on UAER
(independent of BP reduction) of
valsartan treatment in patients with type
2 diabetes and microalbuminuria in
comparison with amlodipine treatment
Methods:
332 patients 35-75 years with type 2 diabetes and
microalbuminuria, with or without hypertension
Valsartan 80 mg od (n=169) or amlodipine 5 mg
od (n=163) for 24 weeks
Target blood pressure 135/85 mm Hg
Viberti et al, Circulation. 2002;106;672-678
Mean BP Effects in Type 2 Diabetic Patients
with MicroAlbuminuria (MARVAL)
Mean 
from baseline
(mm Hg)
at 24 weeks
Valsartan
Amlodipine
-11.2 -11.6
SBP
-6.6
-6.5
DBP
Viberti et al, Circulation. 2002;106;672-678
MARVAL: MicroAlbuminuria
Reduction With Valsartan
20
UAER
0
%
change
from -20
baselin
e -40
-8%
Amlodipine
-44%
Valsartan
-60
0
4
8
12
Weeks
Viberti et al, Circulation. 2002;106;672-678
18
24
P < 0.001
MARVAL: MicroAlbuminuria
Reduction With Valsartan
% of Patients Returning to Normoalbuminuria* Status
35
30
29.9% †
Valsartan
Amlodipine
25
20
14.5%
15
10
5
0
* Defined as UAER < 20 g/min
†
P=0.001 vs. amlodipine
MARVAL: Conclusions
• Significant reduction in UAER with valsartan vs.
amlodipine
– reductions observed in groups with / without
hypertension
• More valsartan patients returned to normal levels of
albumin in urine after 24 weeks than amlodipine
patients
• BP reduction comparable between groups
• For same BP reduction, valsartan was significantly
more effective in reducing UAER in type 2 diabetes
patients with microalbuminuria
Viberti et al, Circulation. 2002;106;672-678