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Quinapril fails to prevent vascular damage in scleroderma
Monday, December 10 2007 | Comments
What's This?
NEW YORK (Reuters Health) - The long-acting angiotensin-converting enzyme (ACE) inhibitor quinapril does not appear to prevent upper limb digital ulcers or other vascular manifestations in patients with limited cutaneous systemic sclerosis (lcSSc), according to UK researchers.Dr. Peter J. Maddison of the University of Wales, Bangor and colleagues studied 210 patients who had lcSSc or Raynaud's phenomenon with SSc-specific antinuclear antibodies. They were randomized in a double-blind fashion to daily quinapril or placebo in addition to their usual therapy.
Follow-up at 2 to 3 years showed that quinapril did not affect the occurrence of digital ulcers or the frequency or severity of Raynaud's episodes, the team reports in the November issue of Arthritis and Rheumatism.
About a fifth of the assigned patients were unable to tolerate quinapril, with a dry or a persistent cough being the most common side effect. There were no serious unexpected adverse reactions.
The investigators conclude that long-term quinapril had no clinical impact on upper limb digital ulcers or on features of microvascular disease in these patients.
"Based on the results of this study," Dr. Maddison told Reuters Health, "I would not recommend the routine use of ACE inhibition in this subgroup of patients with systemic sclerosis."
Arthritis Rheum 2007;56:3837-3846.
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