Previous research has suggested that the use of angiotensin-converting enzyme inhibitors (ACEIs) or aliskiren may triple the risk for angioedema when compared to BB use. For this study, researchers used the US PharMetrics Plus claims database to collect information on hypertensive patients with an antihypertensive prescription from 2007–2012. A nested case-control analysis was conducted to examine the relative angioedema risk of aliskiren or other antihypertensives versus BBs.
The analysis included a total of 3,090,114 patients, with 30,720 of these patients administered aliskiren. Overall there were 15,744 angioedema events resulting in an incidence rate (IR) of 2.28/1000 person-years (95% CI, 2.24–2.32). The IRs for any aliskiren, aliskiren monotherapy, aliskiren fixed-dose combination, and aliskiren free-standing combination were 2.58 (2.08–3.17), 1.71 (0.74–3.37), 1.27 (0.41–2.96), and 2.93 (2.31–3.66), respectively.
The case-control analysis found no significant difference in the angioedema risk for aliskiren monotherapy and fixed-dose combination compared to BBs with adjusted odds ratio of 0.99 (95% CI, 0.45–2.20) and 1.06 (0.40–2.76), respectively.
There was an increased risk of angioedema with free-standing combination aliskiren (adjusted odds ratio: 3.29; 2.42–4.48). However, the researchers believe this may be due to concomitant ACEI use (adjusted odds ratio: 7.03; 4.10–12.05).
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