Drugs

Telmisartan

Telmisartan

Other 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 IIb 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?

What is telmisartan?

Telmisartan is an investigational HIV drug that is being studied to treat HIV infection.2 Telmisartan is also currently approved by the U.S. Food and Drug Administration (FDA) to treat high blood pressure and lower the risk of heart attack, stroke, or death in certain people who are at high risk for developing heart-related problems.5

As an investigational HIV therapy, telmisartan belongs to a group of 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 immune system. Telmisartan may also help limit the size of the latent HIV reservoir in the body.7–9

To learn about how investigational drugs are tested during clinical trials, read the AIDSinfo What is an Investigational HIV Drug? and HIV/AIDS Clinical Trials fact sheets.

Which clinical trials are studying telmisartan?

Which clinical trials are studying telmisartan?

Study Names: ACTG A5317; TRAFIC study; NCT01928927
Phase: IIb
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 antiretroviral therapy (ART) could reduce fibrosis in lymph nodes or in fat tissue.4,10

Study Names: SEARCH 018; NCT02750059
Phase: II
Status: This study is ongoing, but not recruiting participants.
Location: Thailand
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 central nervous system (CNS). Investigators will also assess whether telmisartan plus ART can limit fibrosis in lymph nodes.11

Note: A separate SEARCH 018 study record (NCT02170246) is also listed on ClinicalTrials.gov. This study is a Phase I trial that will look at the effect of telmisartan plus ART on HIV reservoir size in the CNS. The study is currently recruiting participants.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 II 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 II study that evaluated whether telmisartan could reduce the amount of fat in adults who were on ART.14
  • TAILoR (EudraCT: 2012-000935-18), a Phase II trial that evaluated whether using telmisartan in adults on ART could reduce insulin resistance.15

What side effects might telmisartan cause?

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.

MATH (NCT01088295):

No participants experienced a side effect related to telmisartan during this study.16

TAILoR (EudraCT: 2012-000935-18):

In this study, some participants received telmisartan and some participants received no study drug. The number of serious side effects reported was similar between those who received telmisartan and those who did not.15,17

Additional information on side effects known to be associated with telmisartan can be found in the FDA-approved Full Prescribing Information for Micardis.5

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.

Where can I get more information about clinical trials studying telmisartan?

Where can I get more information about clinical trials studying telmisartan?

More information about telmisartan-related research studies is available from the AIDSinfo database of ClinicalTrials.gov study summaries. Click on the title of any trial in the list to see the ClinicalTrials.gov trial summary and more information about the study.

Some clinical trials may be looking for volunteer participants. Your health care provider can help you decide whether participating in a clinical trial is right for you. For information, visit NIH Clinical Trials and You.

References

References

  1. United States National Library of Medicine. ChemIDplus Advanced: Telmisartan. https://chem.nlm.nih.gov/chemidplus/rn/144701-48-4. Accessed December 30, 2018.
  2. Treatment Action Group website. Research toward a cure trials. http://www.treatmentactiongroup.org/cure/trials. Accessed December 30, 2018.
  3. DrugBank. Telmisartan. https://www.drugbank.ca/drugs/DB00966. Accessed December 30, 2018.
  4. 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 December 30, 2018.
  5. 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 December 30, 2018.
  6. 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
  7. Douek DC. Immune activation, HIV persistence, and the cure. Top Antivir Med. 2013;21(4):128-132.
  8. 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 December 30, 2018.
  9. 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.html. Accessed December 30, 2018.
  10. 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 December 30, 2018.
  11. 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 December 30, 2018.
  12. 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 December 30, 2018.
  13. 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 December 30, 2018.
  14. 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 December 30, 2018.
  15. 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 December 30, 2018.
  16. Lake JE, Tseng C-H, Currier JS. A pilot study of telmisartan for visceral adiposity in HIV infection: the metabolic abnormalities, telmisartan, and HIV infection (MATH) trial. PLoS ONE. 2013;8(3). doi:10.1371/journal.pone.0058135
  17. Pushpakom S, Kolamunnage-Dona R, Taylor C, et al. Telmisartan for the reduction of insulin resistance in HIV-positive individuals on combination antiretroviral therapy: an adaptive design dose-ranging Phase II randomised trial. Abstract presented at: European AIDS Conference; October 25-27, 2017; Milan, Italy. Abstract PE12/19. http://resourcelibrary.eacs.cyim.com/mediatheque/media.aspx?mediaId=34347&channel=28172. Accessed December 30, 2018.

Last Reviewed: December 30, 2018