Triplixam (perindopril arginine/amlodipine/indapamide) / Servier - LARVOL DELTA

Real-world analysis of adherence, persistence, and outcomes in patients receiving four-drug antihypertensive therapy. (PubMed, Eur Heart J Cardiovasc Pharmacother) - "In patients receiving four-drug antihypertensive therapy, adherence and persistence were significantly improved with lower pill burden. Persistence was associated with lower risks of CVE and mortality."

Journal • Real-world evidence • Cardiovascular • Hypertension

Levothyroxine malabsorption and macroTSH in a woman with refractory hypothyroidism (ETA 2026) - "Regular medication included LT4 275 micrograms daily, metformin plus dapagliflozin, perindopril plus indapamide plus amlodipine, and oral iron. Persistent elevation of TSH in patients receiving high dose of LT4 requires systematic evaluation beyond adherence. This case underscores that concomitant LT4 malabsorption and macroTSH can underlie severe hypothyroidism, profoundly distorting biochemical assessment and masking true hormone status. Early consideration of assay interference and absorption defects, coupled with close collaboration between clinicians and the laboratory, is crucial to correctly interpret thyroid function, tailor LT4 dosing and prevent unnecessary or inappropriate investigations."

Clinical • Cardiovascular • Celiac Disease • Diabetes • Endocrine Disorders • Gastrointestinal Disorder • Hematological Disorders • Hypertension • Immunology • Metabolic Disorders • Ophthalmology • Type 2 Diabetes Mellitus • Women's Health

Case Report: A reversible autonomic-endothelial migraine pattern: a conceptual perspective illustrated by a clinical case. (PubMed, Front Pain Res (Lausanne)) - "A 41-year-old male with a 10-year history of migraine without aura and vasomotor rhinitis experienced sustained remission after initiation of nebivolol 5 mg and (perindopril 5 mg/indapamide 1.25 mg/amlodipine 5 mg) once daily for mild hypertension. The patient's blood pressure remained within the physiological range throughout the observation period, indicating that the sustained remission extended beyond antihypertensive control per se. This case illustrates a hypothesis-generating clinical pattern potentially involving endothelial and autonomic modulation and highlights how vascular homeostasis and circadian autonomic factors may influence migraine chronification and remission."

Journal • Cardiovascular • CNS Disorders • Hypertension • Inflammation • Migraine • Pain

2020/ABM/01/00037: Optimal medical treatment of difficult-to-treat hypertension. (clinicaltrialsregister.eu) - P3/4 | N=1154 | Recruiting | Sponsor: Narodowy Instytut Kardiologii Stefana Kardynala Wyszynskiego Panstwowy Instytut Badawczy | N=2500 ➔ 1154

Enrollment change • Cardiovascular • Hypertension

Quadruple vs triple therapy for resistant hypertension: the QUADRO trial. (PubMed, Eur Heart J) - P3 | "The first full-dose quadruple antihypertensive SPC (perindopril/indapamide/amlodipine/bisoprolol) demonstrated superiority over perindopril/indapamide/amlodipine, offering an effective alternative therapy for confirmed resistant hypertension."

Journal • Cardiovascular • Hypertension

FastControl: Rapid Management of Resistant Hypertension in the Public Health System (Fast Control) (clinicaltrials.gov) - P=N/A | N=142 | Recruiting | Sponsor: Instituto Dante Pazzanese de Cardiologia

New trial • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

Impact of Single-Pill Combination Therapy on Nocturnal Blood Pressure Dipping in Indian Patients: A Subanalysis from the TOPSPIN Trial (AHA 2025) - "Data on dipping status and its modulation by Single-Pill Combination (SPC) therapy in Indian or South Asian populations is sparse.Objectives: To evaluate the prevalence and predictors of nocturnal BP dipping patterns in Indian hypertensive patients and the efficacy of three SPCs on restoring dipping status. TOPSPIN was a multicenter, randomized, single-blind trial of 1981 Indian adults with hypertension, treated with three SPCs: amlodipine–perindopril, perindopril–indapamide, and amlodipine–indapamide... Non-dipping is highly prevalent among Indian hypertensive patients. Six months of SPC reduced overall BP but had a clinically minimal impact on restoring nocturnal dipping, with no significant differences across treatment arms."

Clinical • Combination therapy • Cardiovascular • Diabetes • Hypertension • Metabolic Disorders

Comparison of dual therapies for hypertension treatment in India: a randomized clinical trial. (PubMed, Nat Med) - P4 | "Furthermore, no significant differences in secondary outcomes, such as mean day and night ambulatory and office BPs and hypertension control rates, were observed among the study groups. Thus, in Indian patients, amlodipine-perindopril, perindopril-indapamide and amlodipine-indapamide were all equally well tolerated and equally highly effective in reducing 24-hour ambulatory and office BPs (ClinicalTrials.gov registration: NCT05683301 )."

Clinical • Journal • Cardiovascular • Hypertension

Evaluation of the Antihypertensive effectIveness, Tolerability, and Adherence With Amlodipine/ Indapamide/ Perindopril Triple Single-pill Combination in Hypertensive Patients Without Concomitant Antihypertensive Therapy (TRIPTYCH) (clinicaltrials.gov) - P=N/A | N=396 | Completed | Sponsor: Servier Russia | Not yet recruiting ➔ Completed | Trial completion date: Feb 2025 ➔ Jun 2025 | Trial primary completion date: Dec 2024 ➔ Apr 2025

Trial completion • Trial completion date • Trial primary completion date • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

ROSUVASTATIN INDUCED ACUTE KIDNEY INJURY – A CASE REPORT (ERA 2025) - "The patient was discharged with additional therapy consisting of perindopril, indapamide, amlodipine, and moxonidine. To our knowledge and based on a review of the literature, this is so far the only case of combined AIN and secondary MCD induced by rosuvastatin use. In our patient, who had no other potential cause of acute kidney failure, eight weeks of rosuvastatin therapy led to acute renal injury with nephrotic syndrome. Kidney biopsy findings showed interstitial infiltrates predominantly composed of eosinophils and extensive podocyte foot processes effacement."

Case report • Clinical • Acute Kidney Injury • Chronic Cough • Cough • Dermatology • Dyslipidemia • Endocrine Disorders • Eosinophilia • Glomerulonephritis • Metabolic Disorders • Mixed Hyperlipidemia • Nephrology • Pain • Pruritus • Renal Disease • Respiratory Diseases

Application of spectrophotometry in novel simultaneous dissolution profiling of a single pill triple therapy of amlodipine, perindopril and indapamide; whiteness evaluation. (PubMed, BMC Chem) - "Simple, diverse univariate spectrophotometric methods were developed and validated for the determination of amlodipine besylate (AM), perindopril arginine (PE), and indapamide (ID). These methods were successfully applied to determine AM, PE, and ID in bulk powder, as well as in Triplixam® tablets, without interference from excipients and in different used dissolution media. The whiteness of the method was evaluated, demonstrating its excellent environmental, analytical and practical efficiency."

Journal

TOPSPIN- A Three-arm Randomized Trial For Treatment Optimisation Of Blood Pressure With Single-pill Combinations In India (AHA 2024) - P4 | "Participants were randomized 1:1:1 to receive a SPC of starting doses of either - amlodipine and perindopril or perindopril and indapamide or amlodipine and indapamide...The results of this trial may have major clinical implications for improving BP control in India and the South Asian diaspora. (CTRI/2022/04/042106 & NCT05683301)"

Clinical • Late-breaking abstract • Cardiovascular • CNS Disorders • Diabetes • Hypertension • Metabolic Disorders • Renal Disease • Vascular Neurology

TOPSPIN: Treatment Optimisation for Blood Pressure With Single-Pill Combinations in India (clinicaltrials.gov) - P4 | N=1981 | Completed | Sponsor: Centre for Chronic Disease Control, India | Active, not recruiting ➔ Completed

Trial completion • Cardiovascular • Hypertension

TOPSPIN: Treatment Optimisation for Blood Pressure With Single-Pill Combinations in India (clinicaltrials.gov) - P4 | N=1981 | Active, not recruiting | Sponsor: Centre for Chronic Disease Control, India | Recruiting ➔ Active, not recruiting | Trial completion date: Dec 2023 ➔ Sep 2024 | Trial primary completion date: Dec 2023 ➔ Aug 2024

Enrollment closed • Trial completion date • Trial primary completion date • Cardiovascular • Hypertension

Efficacy and safety of a single-pill versus free combination of perindopril/indapamide/amlodipine: a multicenter, randomized, double-blind study in Chinese patients with hypertension. (PubMed, J Hypertens) - "Per/Ind/Aml is an effective substitute for Per/Ind + Aml, providing at least equivalent BP control over 24 h in a single pill, with comparable safety."

Clinical • Journal • Acute Myelogenous Leukemia • Cardiovascular • Hypertension

OPTIMAL-HT: Optimal Medical Treatment of Difficult-to-treat Hypertension (clinicaltrials.gov) - P4 | N=2500 | Recruiting | Sponsor: National Institute of Cardiology, Warsaw, Poland

New P4 trial • Cardiovascular • Hypertension

Evaluation of the Antihypertensive effectIveness, Tolerability, and Adherence With Amlodipine/ Indapamide/ Perindopril Triple Single-pill Combination in Hypertensive Patients Without Concomitant Antihypertensive Therapy (TRIPTYCH) (clinicaltrials.gov) - P=N/A | N=375 | Not yet recruiting | Sponsor: Servier Russia

Adherence • New trial • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

Efficacy and Organoprotection of Triple Combinations in the Treatment of Arterial Hypertension (PubMed, Kardiologiia) - "Combination antihypertensive therapy with a renin-angiotensin-aldosterone system inhibitor, amlodipine, and thiazide/thiazide-like diuretics provides a better blood pressure control compared to other antihypertensive drug combinations. The use of the triple combination of amlodipine/indapamide/perindopril is associated with a better metabolic profile than any other considered combination of antihypertensive drugs and a more pronounced organ-protective effect."

Journal • Cardiovascular • Hypertension • Pulmonary Arterial Hypertension

A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy. (PubMed, J Hypertens) - "The SPC of PER/IND/AML, compared with multiple-pill combination, is associated with higher adherence to medication, lower incidence of CV events and mortality, and reduced healthcare costs."

HEOR • Journal • Real-world • Real-world evidence • Retrospective data • Acute Myelogenous Leukemia • Cardiovascular

Marginal Zone B Cell Lymphoma and Non-HCV Associated Type II Cryoglobulinemic Vasculitis: A Rare Presentation (EADV 2023) - "She was taking atorvastatin, methylprednisolone (MP) 15 mg, levothyroxine, perindopril arginine, indapamide, amlodipine, vildagliptin, metformin, insulin, colchicine, pregabalin, alpha lipoic acid...A rituximab-bendamustine regimen for NMZL was planned. Entecavir treatment was started for prophylaxis of hepatitis B reactivation... Type I CG consists of monoclonal IgM or IgG; Type II consists of monoclonal IgM/polyclonal IgG immune complexes; Type III consists of polyclonal IgM and IgG. In Type II and III Mixed Cryoglobulinemia (MC), the IgM fraction has RF activity. Type I CG is usually associated with monoclonal gammopathies, whereas MC is associated with infections (HCV, HBV), autoimmune diseases, B-cell lymphomas, or solid neoplasms."

Anemia • Cardiovascular • Complement-mediated Rare Disorders • Diabetes • Diabetic Neuropathy • Endocrine Disorders • Fatigue • Fibrosis • Glomerulonephritis • Hematological Disorders • Hematological Malignancies • Hepatitis B • Hepatitis C • Hepatology • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Lupus Nephritis • Lymphoma • Marginal Zone Lymphoma • Metabolic Disorders • Monoclonal Gammopathy • Musculoskeletal Pain • Myositis • Nephrology • Non-Hodgkin’s Lymphoma • Oncology • Pain • Rheumatoid Arthritis • Scleroderma • Solid Tumor • Systemic Sclerosis • Thrombocytosis • Type 2 Diabetes Mellitus • Vasculitis

Efficacy and safety of perindopril/indapamide/amlodipine single-pill combination in essential hypertension (ESC 2023) - "Perindopril/Indapamide/Amlodipine SPC is as effective and safe as the free combination in hypertensive patients uncontrolled with dual therapy of Perindopril/Indapamide. The uptitration to higher dosages of the triple-drug SPC provided additional benefit on BP lowering and BP control without increasing pill burden."

Clinical • Cardiovascular • Hypertension • Hypotension

In the prevention of dementia, the focus should be on early and consistent treatment of hypertension. (PubMed, Vnitr Lek) - "To achieve rapid and effective hypertension control, a combination of antihypertensive drugs is usually required. Using a fixed-dose triple combination of perindopril, indapamide, and amlodipine, blood pressure targets of < 130/80 mm Hg can be achieved within three months in 93 % of patients."

Journal • Alzheimer's Disease • Cardiovascular • CNS Disorders • Dementia • Hypertension

Bioequivalence Study of Perindopril /Amlodipine/Indapamide 8 mg (10 mg)/2.5 mg/10 mg Tablets in Healthy Volunteers Under Fasting Conditions (clinicaltrials.gov) - P1 | N=50 | Recruiting | Sponsor: Pharmtechnology LLC

New P1 trial

Vascular stiffness parameters as additional criteria for the effectiveness of antihypertensive therapy when switching from free combinations to a fixed triple combination (HEART FAILURE 2023) - "Conclusions. Indicators of vascular stiffness, together with target BP figures, can serve as criteria for monitoring the quality of blood pressure and have been used to assess the effectiveness of antihypertensive therapy when switching patients to TFC amlodipine/indapamide/perindopril."

Cardiovascular • Hypertension

Efficacy and Safety of Perindopril 5 mg / Indapamide 1.25 mg / Amlodipine 5 mg Fixed Combination in Hypertension (clinicaltrials.gov) - P3 | N=532 | Completed | Sponsor: Institut de Recherches Internationales Servier

New P3 trial • Cardiovascular • Hypertension