Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
PLoS Curr. 2013 Dec 12;5. pii: ecurrents.md.2cc69a1dae4be7dfe2bcb420024ea865. doi: 10.1371/currents.md.2cc69a1dae4be7dfe2bcb420024ea865.

A randomized, double-blind trial of lisinopril and losartan for the treatment of cardiomyopathy in duchenne muscular dystrophy.

Author information

  • 1Center for Gene Therapy, Heart Center, and Wellstone Cooperative Muscular Dystrophy Research Center, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA; Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
  • 2Departments of Neurology and Pediatrics, The Ohio State University, Columbus, Ohio, United States; Center for Gene Therapy, Nationwide Children's Hospital, Columbus, Ohio, United States.
  • 3Center for Gene Therapy, Heart Centre, and Wellstone Cooperative Muscular Dystrophy Research Center, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA.
  • 4Center for Mathematical Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA; Department of Pediatrics, The Ohio State University, Columbus, Ohio, USA.
  • 5St. Louis Children's Hospital, Washington University College of Medicine, St. Louis, Missouri, USA.
  • 6University of California Davis, Davis, California, USA.
  • 7The University of Minnesota College of Medicine, Minneapolis, Minnesota, USA.
  • 8Boston Children's Hospital, Harvard Medical School, Boston, USA.
  • 9Boston Children's Hospital, Harvard College of Medicine, Boston, Massachusetts, USA.
  • 10Departments of Neurology and Pediatrics, The Ohio State University, Columbus, Ohio, USA; Center for Gene Therapy, Nationwide Children's Hospital, Columbus, Ohio, USA.

Abstract

OBJECTIVES:

This study sought to compare the effectiveness and safety of an angiotensin converting enzyme inhibitor (ACE-I) (lisinopril) vs. an angiotensin receptor blocker (ARB) (losartan) for the treatment of cardiomyopathy (CM) in boys with Duchenne muscular dystrophy (DMD).

BACKGROUND:

Development of CM is universal in boys with DMD. ACE-I and ARB have both been suggested as effective treatment options. ARBs have been associated with skeletal muscle regeneration in a mouse model of DMD. The question of which, if either, is more effective for CM treatment in DMD remains. The purpose of this multicenter double-blind prospective study was to compare efficacy and safety of lisinopril versus losartan in the treatment of newly diagnosed CM in boys with DMD.

METHODS:

Echocardiographic technician inter- and intraobserver variability were tested on 2 separate days on 2 different boys with DMD CM. Results were compared with paired t-testing. Twenty-two boys with newly diagnosed DMD CM (echocardiographic ejection fraction (EF) 10% EF drop. Three boys in the aCE-I group had 3 visits, due to study funding termination. Two were withdrawn because of low EF. All their data are included in the analysis for as long as they remained in the study. Mean EF's were similar at baseline (47.5%- ACE-I, 48.4%- ARB). After 1 year each group significantly improved to 54.6% and 55.2% respectively (p=.02). There was no difference between the 2 treatment groups at 1 year.

CONCLUSIONS:

Inter-observer and intra-observer reliability studies showed no differences between echocardiographers on serial examinations. EF improved equally in the two groups. There is no therapeutic difference in EF improvement between lisinopril and losartan over the one-year duration for treatment of boys with DMD-related CM.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01982695.

PMID:
24459612
[PubMed]
PMCID:
PMC3871420
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Public Library of Science Icon for PubMed Central
    Loading ...
    Write to the Help Desk