Candesartan Has Limited Effectiveness for Diabetic Retinopathy

29 sept 2008--Candesartan, an angiotensin II receptor blocker, modestly reduces the development of retinopathy in type 1 diabetes and encourages regression of the condition in type 2 diabetes, according to two Lancet reports released online.
In separate studies, industry-funded researchers randomized 3300 patients with type 1 diabetes and 1900 with type 2 diabetes to either daily candesartan or placebo, with follow-up for a median 4.7 years. (Type 1 diabetics were normotensive, and patients with type 2 disease could be either normotensive or receiving treatment for hypertension.)
Type 1 diabetics on candesartan had a modest reduction in the incidence of retinopathy, but there was no effect on progression among those who already had retinopathy.
Among type 2 diabetics with established retinopathy, candesartan lowered the risk for progression of the complication, although not significantly. The drug also prompted regression among those with early retinopathy.
Commentators conclude that candesartan has benefits, but "with some caveats" about their limit.
LINK(S):
Lancet article on candesartan in type 1 diabetes (Free abstract; full text requires subscription)
Lancet article on candesartan in type 2 diabetes (Free abstract; full text requires subscription)
Lancet comment (Subscription required)