Evidence mapPaperPMID 39085979Full record

ArticleClinical hypertension2024

Blood pressure control in diabetic kidney disease: a post-hoc analysis of the FANTASTIC trial.

Cheol Ho Park, Soon Jun Hong, Sung Gyun Kim, Seok Joon Shin, Dong Ki Kim, Jung Pyo Lee, Sang Youb Han, Sangho Lee, Jong Chul Won, Young Sun Kang and 7 more

Registry-linked trialAbstract read
In one paragraph

Article in Clinical hypertension, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02620306 (A Randomized, Double-blind, Active Control, Parallel Group, Titration, Multicenter Study to Evaluate the Efficacy and Safety of Fimasartan), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
field-weighted citation impact
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.

NCT02620306 phase3completednot on this map

A Randomized, Double-blind, Active Control, Parallel Group, Titration, Multicenter Study to Evaluate the Efficacy and Safety of Fimasartan

TypeinterventionalSponsorBoryung Pharmaceutical Co., LtdRan2016 to 2022Enrolled351ConditionsChronic Kidney DiseaseArmsFimsartan 60mg~120mg, Losartan 50mg~100mg
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Cheol Ho Park *Department of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
Soon Jun Hong *Department of Cardiology, Korea University Anam Hospital, Seoul, Republic of Korea.
Sung Gyun KimDivision of Nephrology, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
Seok Joon ShinDivision of Nephrology, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea.
Dong Ki KimDepartment of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jung Pyo LeeDepartment of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Sang Youb HanDivision of Nephrology, Inje University Ilsan-Paik Hospital, Goyang, Republic of Korea.
Sangho LeeDepartment of Nephrology, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.
Jong Chul WonDivision of Endocrinology and Metabolism, Inje University Sanggye Paik Hospital, Inje University School of Medicine, Seoul, Republic of Korea.
Young Sun KangDivision of Nephrology, Korea University Ansan Hospital, Ansan, Republic of Korea.
Jongha ParkDivision of Nephrology, Ulsan University Hospital, Ulsan, Republic of Korea.
Byoung-Geun HanDivision of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Ki-Ryang NaDivision of Nephrology, Chungnam National University Hospital, Daejeon, Republic of Korea.
Kyu Yeon HurDivision of Endocrinology and Metabolism, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Yong-Jin KimDivision of Cardiology, Seoul National University Hospital, Seoul, Republic of Korea.
Sungha ParkDivision of Cardiology, Severance Cardiovascular Hospital, Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea. shpark0530@yuhs.ac.
Tae-Hyun YooDepartment of Internal Medicine, Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul, Republic of Korea. yoosy0316@yuhs.ac.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe target blood pressure (BP) value is unclear for diabetic kidney disease (DKD). Therefore, we aimed to evaluate the effect of strict BP control or 'on treatment' BP on clinical outcomes in patients with DKD.

methodsA post-hoc analysis of the prespecified secondary outcomes of the FimAsartaN proTeinuriA SusTaIned reduCtion in comparison with losartan in diabetic chronic kidney disease (FANTASTIC) trial, a randomized multicenter double-blind phase III trial. Eligible patients were aged ≥ 19 years with DKD. We assigned 341 participants with DKD to BP control strategy (standard-systolic BP [SBP] < 140 mmHg versus strict-SBP < 130 mmHg). The outcome was the occurrence of cardiovascular events and renal events. Separate analyses were performed to compared the risk of outcome according to achieved average BP levels.

resultsA total of 341 participants were included in the analysis. Over a median follow-up of 2.8 years, cardiovascular/renal events were observed in 25 (7.3%) participants. Mean (SD) SBPs in the standard and strict BP control group were 140.2 (11.6) and 140.2 (11.9) mmHg, respectively. The strict BP control group did not show significantly reduced risk of cardiovascular/renal events (HR 1.32; 95% CI 0.60-2.92]). In the post-hoc analyses using achieved BP, achieved average SBP of 130-139 mmHg resulted in reduced risk of cardiovascular/renal events (HR 0.15; 95% CI 0.03-0.67) compared to achieved average SBP ≥ 140 mmHg, whereas further reduction in achieved average SBP < 130 mmHg did not impart additional benefits.

conclusionIn patients with DKD, targeting a SBP of less than 130 mmHg, as compared with less than 140 mmHg, did not reduce the rate of a composite of cardiovascular and renal events. Achieved SBP of 130-139 mmHg was associated with a decreased risk for the primary outcome in patients with DKD.

trial registrationClinicalTirals.gov Identifier: NCT02620306, registered December 3, 2015. ( https://clinicaltrials.gov/study/NCT02620306 ).

Indexed as

Blood pressureCardiovascular outcomeDiabetic kidney diseaseKidney outcome

Identifiers

PMID39085979
PMCPMC11293031

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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 Socratic graph.