Extrait de Medscape
The drug is the first in a new class of agents known as oral renin inhibitors and is approved for the treatment of high blood pressure as monotherapy or in combination with other antihypertensive medications. The drug is expected to be available in pharmacies this month in 150-mg and 300-mg doses.
A once-daily oral tablet, aliskiren blocks the action of renin at the top of the renin-angiotensin-system cascade. It reduces blood pressure effectively regardless of age or gender, is well tolerated, and appears to be additive to most other antihypertensive agents, with the exception of angiotensin-receptor blockers.
"Clearly, a new drug with a unique mechanism of action is a welcome addition. However, there are several questions coming to mind. Is there a need for triple blockade of the renin angiotensin system, and if so, what is the risk/benefit ratio? If the prorenin story plays out--and that's a big if--conceivably aliskiren will have distinct advantages in the diabetic patient. From a purely antihypertensive point of view, I cannot conceive that a drug that has a very similar shallow dose-response curve as the angiotensin-receptor inhibitors but seems to have more adverse effects will confer a distinct advantage."
Where aliskiren might be advantageous is in patients who cannot take ACE inhibitors because of cough or angioedema or those who need a double blockade of the renin angiotensin system, such as diabetic patients with albuminuria.