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Significant Microalbuminuria Reduction with Valsartan vs. Amlodipine in Type 2 Diabetes Patients

The MARVAL study assessed the impact of valsartan treatment on urinary albumin excretion rate (UAER) in patients with type 2 diabetes and microalbuminuria, comparing it to amlodipine. Involving 332 participants aged 35 to 75, the study found that valsartan (80 mg) led to a significantly greater reduction in UAER over 24 weeks compared to amlodipine (5 mg), irrespective of blood pressure changes. Notably, more patients treated with valsartan achieved normoalbuminuria status than those on amlodipine, highlighting valsartan's efficacy in managing diabetes-related renal complications.

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Significant Microalbuminuria Reduction with Valsartan vs. Amlodipine in Type 2 Diabetes Patients

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  1. חזקבהגנהכלייתית לדיובןהגנה כלייתית מוכחת בחולי סכרת מסוג 2, (היפרטנסיבים ונורמוטנסיבים)עם מיקרואלבומינוריה

  2. MARVAL: MicroAlbuminuria Reduction With Valsartan Objective:To assess the effects on UAER (independent of BP reduction) of valsartan treatment in patients with type 2 diabetes and microalbuminuria in comparison with amlodipine treatment Methods:332 patients 35-75 years with type 2 diabetes and microalbuminuria, with or without hypertension Valsartan 80 mg od (n=169) or amlodipine 5 mg od (n=163) for 24 weeks Target blood pressure 135/85 mm Hg Viberti et al, Circulation. 2002;106;672-678

  3. Mean BP Effects in Type 2 Diabetic Patientswith MicroAlbuminuria (MARVAL) Valsartan Amlodipine Mean  from baseline (mm Hg) at 24 weeks -11.2 -11.6 -6.6 -6.5 SBP DBP Viberti et al, Circulation. 2002;106;672-678

  4. MARVAL: MicroAlbuminuria Reduction With Valsartan 20 UAER % change from baseline -8% 0 Amlodipine -20 -44% -40 Valsartan -60 0 4 8 12 18 24 Weeks P < 0.001 Viberti et al, Circulation. 2002;106;672-678

  5. MARVAL: MicroAlbuminuria Reduction With Valsartan % of Patients Returning to Normoalbuminuria* Status 35 Valsartan Amlodipine 29.9% † 30 25 20 14.5% 15 10 5 0 * Defined as UAER < 20 g/min † P=0.001 vs. amlodipine

  6. MARVAL: Conclusions • Significant reduction in UAER with valsartan vs. amlodipine • reductions observed in groups with / without hypertension • More valsartan patients returned to normal levels of albumin in urine after 24 weeks than amlodipine patients • BP reduction comparable between groups • For same BP reduction, valsartan was significantly more effective in reducing UAER in type 2 diabetes patients with microalbuminuria Viberti et al, Circulation. 2002;106;672-678

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