TelmisartanOther Names: Micardis, TEL Drug Class: Antifibrotics Molecular Formula: C33 H30 N4 O2 Registry Number: 144701-48-4 (CAS) Chemical Name: (1,1'-Biphenyl)-2-carboxylic acid, 4'-((1,4'-dimethyl-2'-propyl(2,6'-bi-1H-benzimidazol)-1'-yl)methyl)- Chemical Class: Biphenyls and derivatives Phase of Development: Telmisartan is in Phase 2b development as an antifibrotic agent for HIV treatment.
(Compound details obtained from ChemIDplus Advanced,1 Treatment Action Group website,2 DrugBank,3 and ClinicalTrials.gov4)
What is telmisartan?
Telmisartan is a drug that has been approved by the(FDA) to treat high blood pressure and lower the risk of heart attack, , or death in certain people who are at high risk for developing heart-related problems.5 Telmisartan is also being studied as an to treat HIV .2
As an investigational HIV drug, telmisartan belongs to a group of HIV drugs called antifibrotics.2 Antifibrotics are medicines that can reduce tissue scarring in the body.6 (Tissue scarring is also called fibrosis.)
By reducing fibrosis, telmisartan may potentially improve the health of the. Telmisartan may also help limit the size of the in the body.7–9
Which clinical trials are studying telmisartan?
Study Names: ACTG A5317; TRAFIC study; NCT01928927
Status: This study has been completed.
Location: United States and Puerto Rico
Purpose: The purpose of this study was to evaluate whether telmisartan along with (ART) could reduce fibrosis in or in fat tissue.4,10
Study Names: SEARCH 018; NCT02750059
Status: This study is ongoing, but not recruiting participants.
Purpose: The purpose of this study is to evaluate whether using telmisartan plus ART in individuals who are in the earliest stage of HIV infection can limit HIV reservoirs from establishing in the (CNS). Investigators will also assess whether telmisartan plus ART can limit fibrosis in nodes.11
Note: A separate SEARCH 018 study record (NCT02170246) is also listed on . This study is a that evaluated the effect of telmisartan plus ART on HIV reservoir size. The study has been completed.2,12
For more details on the studies listed above, see the Health Professional version of this drug summary.Besides being studied for its impact on fibrosis and the HIV reservoir, telmisartan has also been studied for its effects on other health outcomes in people with HIV. These completed studies include:
- NCT01578772, a Phase 2 study that assessed whether telmisartan could improve the function of blood vessels in older adults who were on ART and at risk for heart-related problems.13
- MATH (NCT01088295), a Phase 2 study that evaluated whether telmisartan could reduce the amount of fat under the skin or in body organs (called adipose tissue) in adults who were on ART.14
- TAILoR (EudraCT: 2012-000935-18), a that evaluated whether using telmisartan in adults on ART could reduce .15
What side effects might telmisartan cause?
One goal of HIV research is to identify new drugs that have fewer side effects. The following side effects were observed in some of the studies of telmisartan listed above.ACTG A5317; TRAFIC study (NCT01928927)
In this study, participants received either ART plus telmisartan or ART alone. In the ART plus telmisartan group, three severe or life-threatening side effects were reported, but none of them were related to telmisartan.16
Because telmisartan is still being studied, information on possible side effects of the drug is not complete. As testing of telmisartan continues, additional information on possible side effects will be gathered.
Additional information on side effects known to be associated with telmisartan can be found in the FDA-approved Micardis Full Prescribing Information.5
Where can I get more information about clinical trials studying telmisartan?
More information about telmisartan-related research studies is available from ClinicalTrials.gov.
- United States National Library of Medicine. ChemIDplus Advanced: Telmisartan. https://chem.nlm.nih.gov/chemidplus/rn/144701-48-4. Accessed September 30, 2019
- Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed September 30, 2019
- DrugBank. Telmisartan. https://www.drugbank.ca/drugs/DB00966. Accessed September 30, 2019
- AIDS Clinical Trials Group. Effects of telmisartan on fibrotic and inflammatory contributors to end-organ disease in HIV-infected patients well controlled on antiretroviral therapy. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered August 22, 2013. NLM Identifier: NCT01928927. https://clinicaltrials.gov/ct2/show/NCT01928927. Accessed September 30, 2019
- Boehringer Ingelheim Pharmaceuticals, Inc. Micardis: full prescribing information, October 25, 2018. DailyMed. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=cfb9309f-e0df-4a55-9542-0e869fce05fb. Accessed September 30, 2019
- Zeng M, Southern PJ, Reilly CS, et al. Lymphoid tissue damage in HIV-1 infection depletes naïve T cells and limits T cell reconstitution after antiretroviral therapy. PLoS Pathog. 2012;8(1). doi:10.1371/journal.ppat.1002437
- Douek DC. Immune activation, HIV persistence, and the cure. Top Antivir Med. 2013;21(4):128-132.
- AIDS Clinical Trials Group website. HIV treatment associated with reduced scar tissue in fat, lymph nodes of people living with HIV. https://actgnetwork.org/node/815452. Accessed September 30, 2019
- Valcour Lab website. SEARCH 018: adjunctive therapy with telmisartan instituted with ART during acute HIV infection to reduce the establishment of CNS reservoirs of HIV and lymph node fibrosis. http://valcourlab.ucsf.edu/search-018-old.html. Accessed September 30, 2019
- Utay NS, Kitch D, Fichtenbaum C, et al. Telmisartan does not improve lymph node or fat fibrosis in treated HIV infection. Poster presented at: Conference on Retroviruses and Opportunistic Infections (CROI); February 13-16, 2017; Seattle, WA. Poster 251. http://www.croiconference.org/sites/default/files/posters-2017/251_Utay.pdf. Accessed September 30, 2019
- South East Asia Research Collaboration with Hawaii. Adjunctive therapy with telmisartan instituted with ART during acute HIV infection to reduce the establishment of CNS reservoirs of HIV and lymph node fibrosis. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered May 30, 2015. NLM Identifier: NCT02750059. https://clinicaltrials.gov/ct2/show/NCT02750059. Accessed September 30, 2019
- Yale University. Adjunctive therapy with telmisartan instituted with ART during acute HIV infection to reduce the establishment of central nervous system reservoirs of HIV and lymph node fibrosis [Southeast Asia Research Collaboration with Hawaii (SEARCH) 018]. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered May 22, 2014. NLM Identifier: NCT02170246. https://clinicaltrials.gov/ct2/show/NCT02170246. Accessed September 30, 2019
- University of California, Los Angeles. Telmisartan and Flow-Mediated Dilatation in Older HIV-Infected Patients at Risk for Cardiovascular Disease. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered February 1, 2012. NLM Identifier: NCT01578772. https://clinicaltrials.gov/ct2/show/NCT01578772. Accessed September 30, 2019
- University of California, Los Angeles. Metabolic abnormalities, telmisartan and HIV infection. In: ClinicalTrials.gov. Bethesda (MD): National Library of Medicine (US). Registered March 16, 2010. NLM Identifier: NCT01088295. https://clinicaltrials.gov/ct2/show/NCT01088295. Accessed September 30, 2019
- EU Clinical Trials Register. EudraCT Number: 2012-000935-18; TAILoR – (telmisartan and insulin resistance in HIV): a dose-ranging Phase II randomised open-labelled trial of telmisartan as a strategy for the reduction of insulin resistance in HIV-positive individuals on combination antiretroviral therapy (cART). https://www.clinicaltrialsregister.eu/ctr-search/trial/2012-000935-18/GB. Accessed September 30, 2019
- Utay NS, Kitch DW, Yeh E, et al. Telmisartan Therapy Does Not Improve Lymph Node or Adipose Tissue Fibrosis More Than Continued Antiretroviral Therapy Alone. J Infect Dis. 2018;217(11):1770-1781. doi:10.1093/infdis/jiy064
Last Reviewed: September 30, 2019
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