6/28/23, 11:44 PM ONTARGET (telmisartan) Pathway Feedback Search Clinical Topics Home Studies ONTARGET (telmisartan) ONTARGET (telmisartan) Disease Disease Disease Acute ischemic stroke Coronary artery disease Diabetes m Trial question Is telmisartan superior to ramipril in patients with vascular disease or high-risk diabetes? Study design Multi-center Double blinded RCT Population Characteristics of study participants 27.0% female N = 17118 73.0% male 17118 patients (4581 female, 12537 male) Inclusion criteria: patients with vascular disease or high-risk diabetes without HF Key exclusion criteria: known hypersensitivity or intolerance to angiotensin 2 receptor antagonist or angiotensin-converting enzyme; symptomatic congestive HF; renal artery stenosis; hepatic dysfunction Interventions N=8542 telmisartan (at a dose of 80 mg per day) N=8576 ramipril (at a dose of 10 mg per day) Primary outcome https://web.pathway.md/studies/rec1dvAspdW1Um9KB 1/2 6/28/23, 11:45 PM ONTARGET (telmisartan) Pathway Composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for heart failure 16.7 % 16.7 16.5 12.5 % 8.3 % 4.2 % No significant difference 0.0 % Telmisartan Ramipril No significant difference in composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for HF (16.7% vs. 16.5%; RR 1.01, 95% CI 0.94 to 1.09) Secondary outcomes No significant difference in revascularization (15.1% vs. 14.8%; RR 1.03, 95% CI 0.95 to 1.11) No significant difference in hospitalization for angina (11.2% vs. 10.8%; RR 1.04, 95% CI 0.95 to 1.14) No significant difference in renal impairment (10.6% vs. 10.2%; RR 1.04, 95% CI 0.96 to 1.14) Safety outcomes No significant differences in syncope, diarrhea, HF and AF. Significant differences in cough (1.1% vs. 4.2%), angioedema (0.1% vs. 0.3%), hypotensive symptoms (2.6% vs. 1.7%). Conclusion In patients with vascular disease or high-risk diabetes without HF, telmisartan was not superior to ramipril with respect to the composite of death from cardiovascular causes, myocardial infarction, stroke or hospitalization for HF. Reference ONTARGET Investigators, Yusuf S, Teo KK et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008 Apr 10;358(15):1547-59. Open reference URL https://web.pathway.md/studies/rec1dvAspdW1Um9KB 2/2