Yazarlar : Presented at EHA

Yayın : DGNews

Yayın Yılı : 2014

Pubmed Linki : http://www.docguide.com/lisinopril-improves-proteinuria-sickle-cell-anaemia-without-blood-pressure-side-effects?tsid=5

Konu : Diğer

Literatür İçeriği :  By Lars Jorgensen

MILAN, Italy -- June 17, 2014 -- The angiotensin-converting enzyme inhibitor lisinopril demonstrates safety and efficacy in the treatment of proteinuria in patients with sickle cell anaemia without risking reductions in blood pressure, according to research presented here at the 19th Congress of the European Hematology Association (EHA).

In longer-living patients with sickle cell anaemia, the kidneys are at risk of disease, as the renal medulla becomes hypertonic and acidic, with proteinuria emerging as a common early manifestation of renal disease, explained Aamer Aleem, MD, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, on June 14.

Some earlier studies showed potential benefit from treatment of such cases with lisinopril, leading Dr. Aleem and colleagues to recruit 35 patients with sickle cell anaemia for treatment with the drug.

The patients (mean age, 28.5 years) had mean haemoglobin levels of 9.26 g/dL, haemoglobin F levels of 11.2%, mean lactate dehydrogenase of 369 IU/mL, and mean serum creatinine of 44 µmol/L.

Before treatment with an average dose of lisinopril 5 mg, the patients’ median 24-hour urine protein was 0.3006 g, versus 0.150 g after treatment (P = .01).

At 38 months mean follow-up, 24-hour urine protein levels had lowered in 27 (77%) patients and normalised in 18 (52%) patients. In 2 patients (6%), the protein levels increased, and they remained stable in 6 (17%) patients.

There were no significant differences in systolic and diastolic blood pressures either before or after treatment. Dr. Aleem noted that 19 patients were still on lisinopril.

The main adverse events experienced by the patients were cough, dizziness, and diarrhoea; none of the patients in the study developed deterioration of renal function. The most common reasons for stopping the drug included normalisation of protein, noncompliance, and side effects, and 1 person stopped because of pregnancy.

“Only few patients developed adverse events, which were mild and tolerable,” the researchers noted. “It is unclear for how long to continue lisinopril and whether it can be stopped in patients who normalise urine protein,” they added.

“Larger studies with longer follow-up are needed to address these questions,” concluded the investigators.

[Presentation title: Response to Lisinopril in Patients With Sickle Cell Anemia and Proteinuria. Abstract LB-6186]

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