CHARM program (clinical trials)
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Introduction
Placebo-controlled trials in patients with chronic heart failure.
Study characteristics:
candesartan 32 mg QD (target dose) vs placebo.
3 arm trial
- 2548 patients with LVEF < 40% already taking ACE inhibitor
- 2028 patients with reduced LVEF intolerant of ACE inhibitors
- 3023 patients with LVEF > 40% (19% taking ACE inhibitor)
Mean follow-up of 38 months
Results:
- candesartan improved:
- cardiovascular death
- rehospitalization for heart failure
- probably* all-cause mortality (23% vs 25%)
- benefit greatest for patients with systolic dysfunction
- no evidence of adverse reaction with combination of:
* difference significant after adjustment for potentially confounding clinical variables
More general terms
References
- ↑ Journal Watch 23(21):166, 2003
Pfeffer MA et al Effects of candesartan on mortality and morbidity in patients with chronic heart failure: the CHARM-Overall programme. Lancet 362:759, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678868
McMurray JJV et al Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function taking angiotensin-converting-enzyme inhibitors: the CHARM-Added trial. Lancet 362:767, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678869
Granger CB et al, Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial. Lancet 362:772, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678870
Yusuf S et al Effects of candesartan in patients with chronic heart failure and preserved left-ventricular ejection fraction: the CHARM-Preserved Trial. Lancet 362:777, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678871
White HD Candesartan and heart failure: the allure of CHARM Lancet 362:754, 2003 PMID: https://www.ncbi.nlm.nih.gov/pubmed/13678864