Does Aliskiren Have a Role in Treating Patients with Diabetes?

Despite the theoretical attractiveness of dual blockade of the renin-angiotensin-aldosterone system, combined therapy with an angiotensin-converting–enzyme (ACE) inhibitor plus an angiotensin-receptor blocker (ARB) has not led to improved clinical outcomes in most studies. Now industry-supported researchers have examined whether dual therapy that includes the direct renin inhibitor aliskiren (Tekturna) is worthwhile.

Researchers randomized nearly 8600 patients with type 2 diabetes who were taking ACE inhibitors (44%) or ARBs (56%) to receive aliskiren or placebo. Nearly all patients had hypertension, nearly all had low glomerular filtration rates or proteinuria, and 42% had cardiovascular disease. The trial was stopped prematurely after medi…