There are several classes of anti-hypertensive agents in the world, the most recently developed agent is angiotensin receptor blocker (ARB). There are already 8 ARBs in the market, but still medical unmet need for treatment of hypertension is existed. The ’ideal’ anti-hypertensive agent would have a number of characteristics: (1) effective in lowering blood pressure to recommend goals; (2) high efficacy as monotherapy; (3) rapid onset of effect; (4) convenient once-daily administration to maximize compliance; (5) sustained efficacy over 24 hours; (6) response increases with higher doses (clear dose-response effect); and (7) optimum tolerability profile. ARB is nearly closed to this kind of ’ideal’ anti-hypertensive agent, but there are some issues to be resolved in order to meet current medical need. These are (1) BP lowering is not satisfactory all around the world; (2) adverse effects of anti-hypertensive agents are hurdles to be relieved; (3) sometimes 24 hour coverage is not demonstrated for optimal blood pressure control; (4) monotherapy is not usually enough; (5) safety issues may interfere the use of optimal anti-hypertensive agents; (6) combination may be helpful, but may not be helpful, even harmful to the patients.
Fimasartan was developed by Korean pharmaceutical company, starting from 1999, and got market authorization right in 2010 from Korea. The compound fimasartan was developed via full clinical development pathway from first-in-human phase 1 trial in UK and subsequent phase 1 trials, proof of concept phase 2 trial, dose finding phase 2 trial and confirmatory phase 3 trial in Korea. Recently for the global clinical trial, phase 3 trials of fimasartan were executed in Mexico and Russia, will be followed in China very soon. Also the patient's convenience, the combo products of fimasartan including hydrochlorothiazide, amlodipine and rosuvastatin were developed via relevant clinical development programs.
For the life cycle management, other combo products are currently developed, and phase 3b and phase 4 trials are ongoing in order to achieve new indication in various therapeutic areas. The clinical development of fimasartan is based on rapid-onset of action, efficacious at starting dose and tolerable safety profile.
For the summary, still there is unmet medical need for development of new treatment option in hypertension management and global clinical development is the key success factor for developing ARB in the world.