Published: 12-01-2011 00:00 | Updated: 22-05-2014 11:42

Better result with patent drug in heart failure

In a novel study, published in JAMA, scientists at Karolinska Institutet show that there is a difference in efficacy between two important drugs for heart failure, which previously where believed to be equivalent. According to the study, the drug that is patented and more expensive works better than its cheaper and patent-free counterpart.

Heart failure is one of the most common causes of hospitalization and death, accounting for close to 2 percent of the total health budget in Europe. However, there are drugs that can slow down the progression of heart failure and reduce mortality. Such a group of drugs is known as angiotensin receptor blockers (ARB). The two most common ARBs are candesartan and losartan.

Previously it was believed that these substances had the same effect. However, the current study in JAMA show that candesartan is associated with lower risk of death than losartan. The study involved about 5,000 patients from the Swedish Heart Failure Registry (S-HFR). The scientists note that the findings need to be confirmed in several future studies, but if the results are confirmed it means that heart failure patients treated with an ARB should be given candesartan and not losartan.

"The differences are large, but the result is complicated by the fact that candesartan is a patented substance and relatively expensive, while losartan is now patent-free and cheaper", says Dr Lars Lund at the Department of Medicine, Solna, who led the study.

The research team has general and un-restricted funding from the pharmaceutical company that benefit from the study, but also from the company that is at a disadvantage. The S-HFR is also supported financially by the pharmaceutical industry. However, the study itself has not been sponsored by any private interests.


Association of candesartan vs losartan with all-cause mortality in patients with heart failure.
Eklind-Cervenka M, Benson L, Dahlström U, Edner M, Rosenqvist M, Lund L
JAMA 2011 Jan;305(2):175-82