[Combination Drug Rave ] Ildong aims to treat hypertension and hyperlipidemia with a single pill – Korea Biomedical Review

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In Korea, combination drugs that can treat hypertension and dyslipidemia with one pill have recently started to receive attention. Given the high proportion of dyslipidemia among hypertension patients in Korea, major local pharmaceutical companies are increasing their presence in developing a combination drug that can treat the two illnesses.

According to the Dyslipidemia Fact Sheet 2015, published by the Korean Society of Lipid & Atherosclerosis, two out of three hypertensive patients, or 62.8 percent, and one out of three metabolic syndrome patients, or 32.1 percent, have dyslipidemia.

However, the report showed that only about one-third of diagnosed patients continuously received treatment for dyslipidemia.

Due to such a lower number of patients treated, local drug firms have been introducing a combination drug that adds statin, a representative dyslipidemia drug, to their hypertension treatment.

Recently, companies have even started launching a three-substance combination drug.

The three-substance combination drugs launched currently in Korea includes Daewoong's Olomax (olmesartan medoxomil/amlodipine/rosuvastatin), Ildong's Telostop Plus (telmisartan/amlodipine/rosuvastatin), Boryung's Dukaro (fimasartan/amlodipine/rosuvastatin), and Yuhan Corp.'s Duowell A (telmisartan/amlodipine/rosuvastatin).

One of the most noteworthy of them is Ildong's Telostop Plus.

Launched in 2018, this drug is one of Ildongs series of combination drugs based on telmisartan, an ARB (Angiotensin II receptor blocker)-based hypertension treatment substance.

Telostop Plus is characterized by increased drug compliance by allowing patients with hypertension and hypercholesterolemia to take three drug substances with a single pill.

Notably, Ildong stresses that the drug combines telmisartan, which has the longest half-life in blood concentration and cardiovascular protection among ARB-based blood pressure-lowering agents, with amlodipine, which is a representative CCB (calcium channel blocker)-based hypertension treatment, and rosuvastatin, the most powerful lipid-lowering effect among statin drugs.

The company had also previously published a study in Clinical Therapeutics, an SCI (Science Citation Index)-registered international academic journal, on the drug's improved efficacy and convenience compared to two-drug combination therapy, in 2019.

With such advantages, the drug is rapidly growing in the market for a latecomer. According to UBIST, a drug market research organization, the total outpatient prescription amount for hypertension and dyslipidemia three-substance combination drugs in the first quarter of this year was valued at 5.8 billion won ($5.1 million), in which Telostop Plus accounted for 825.3 million won of the total sales.

Besides Telostop Plus, Ildong also markets a variety of telmisartan-based combination drugs.

The drugs are Telostop (telmisartan/rosuvastatin), hypertension and hyperlipidemia combination drug, and Twotops (telmisartan/amlodipine) and Twotops Plus (telmisartan /amlodipine/hydrochlorothiazide), both hypertension combination drugs.

Telostop is a two-drug combination that adds telmisartan to the HMG-CoA reductase inhibitor rosuvastatin and has both blood pressure and lipid-lowering effect.

By changing the excipient, which is the substance added for the stability and ease of handling the drug, from the existing single drug and adopting a film coating formulation, the company was able to solve the hygroscopic problem pointed out in the current single-component drugs.

Twotops is a treatment for hypertension that contains telmisartan and a calcium channel blocker (CCB), amlodipine, while Twotops Plus added hydrochlorothiazide, a diuretic agent. Twotops Plus has also increased patient convenience as the drug's tablet size is similar to that of the existing two-drug formulations.

The blood pressure-lowering effect of Twotops Plus was also published in the Clinical Therapeutics in 2017, while the company presented the results of clinical research for the drug during the 2017 Korean Heart Association Fall Conference.

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[Combination Drug Rave ] Ildong aims to treat hypertension and hyperlipidemia with a single pill - Korea Biomedical Review