Evidence map›Paper›PMID 19451556›Full record

Trial reportAnnals of internal medicine2009

Effect of telmisartan on renal outcomes: a randomized trial.

Johannes F E Mann, Roland E Schmieder, Leanne Dyal, Matthew J McQueen, Helmut Schumacher, Janice Pogue, Xingyu Wang, Jeffrey L Probstfield, Alvaro Avezum, Ernesto Cardona-Munoz and 9 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Annals of internal medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed, 8 pooled it
17.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 8 syntheses or guidelines pooled it, 194 citations in OpenAlex.

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  4. Assessing the Validity of Surrogate Outcomes for ESRD: A Meta-Analysis.Journal of the American Society of Nephrology : JASN · 2015
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  7. Antihypertensive agents for preventing diabetic kidney disease.The Cochrane database of systematic reviews · 2012
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  9. Multicentre randomized controlled trial of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker withdrawal in advanced renal disease: the STOP-ACEi trial.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2016
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

19 authors at 1 institution in 1 country.

Johannes F E MannSchwabing General Hospital, KfH Kidney Center, Ludwig Maximilians University, Munich, Germany.
Roland E Schmieder
Leanne Dyal
Matthew J McQueen
Helmut Schumacher
Janice Pogue
Xingyu Wang
Jeffrey L Probstfield
Alvaro Avezum
Ernesto Cardona-Munoz
Gilles R Dagenais
Rafael Diaz
George Fodor
Jean M Maillon
Lars Rydén
Cheuk M Yu
Koon K Teo
Salim Yusuf
TRANSCEND (Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) Investigators
Ludwig-Maximilians-Universität München · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAngiotensin-receptor blockers (ARBs) blunt progression of advanced diabetic nephropathy, but their long-term renal effects in other patients are not clear.

objectiveTo examine the long-term renal effects of telmisartan versus placebo in adults at high vascular risk.

designRandomized trial. Patients were randomly assigned by a central automated system between November 2001 and May 2004 and were followed until March 2008. Participants and investigators were blinded to intervention status.

settingMulticenter, multinational study. PATIENTS: 5927 adults with known cardiovascular disease or diabetes with end-organ damage but without macroalbuminuria or heart failure who cannot tolerate angiotensin-converting enzyme inhibitors.

interventionTelmisartan, 80 mg/d (n = 2954), or matching placebo (n = 2972) plus standard treatment for a mean of 56 months. MEASUREMENTS: Composite renal outcome of dialysis or doubling of serum creatinine, changes in estimated glomerular filtration rate (GFR), and changes in albuminuria.

resultsNo important difference was found in the composite renal outcome with telmisartan (58 patients [1.96%]) versus placebo (46 patients [1.55%]) (hazard ratio, 1.29 [95% CI, 0.87 to 1.89]; P = 0.20). Among the telmisartan and placebo groups, 7 and 10 patients had dialysis and 56 and 36 patients had doubling of serum creatinine, respectively (hazard ratio, 1.59 [CI, 1.04 to 2.41]; P = 0.031). Albuminuria increased less with telmisartan than with placebo (32% [CI, 23% to 41%] vs. 63% [CI, 52% to 76%]; P < 0.001). Decreases in estimated GFR were greater with telmisartan than with placebo (mean change in estimated GFR, -3.2 mL/min per 1.73 m(2) [SD, 18.3] vs. -0.26 mL/min per 1.73 m(2) [SD, 18.0]; P < 0.001). LIMITATION: Only 17 participants had dialysis.

conclusionIn adults with vascular disease but without macroalbuminuria, the effects of telmisartan on major renal outcomes were similar to those of placebo.

Indexed as

AgedAlbuminuriaAngiotensin II Type 1 Receptor BlockersBenzimidazolesBenzoatesCoronary Artery DiseaseCreatinineDiabetic NephropathiesDisease ProgressionDouble-Blind MethodFemaleFollow-Up StudiesGlomerular Filtration RateHumansKidney DiseasesMaleAngiotensin II Type 1 Receptor BlockersBenzimidazolesBenzoatesCreatinineTelmisartan

Identifiers

PMID19451556
OpenAlexW2127808551

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.