ARB no better than ACE inhibitor for prevention of nephropathy progression
The Journal of Family Practice. 2005 February;54(2):105-113
February 1, 2005|The Journal of Family Practice
Author and Disclosure Information
- CLINICAL QUESTION: Are angiotensin receptor blockers as good as angiotensin-converting enzyme inhibitors at preventing the progression of nephropathy?
- STUDY DESIGN: Randomized controlled trial (double-blinded)
- ALLOCATION: Uncertain
- SETTING: Outpatient (any)
- SYNOPSIS: This study is what we call DOE (disease-oriented evidence), since it measured progression of nephropathy instead of the patient-oriented outcome of renal failure or need for dialysis. However, the results are worth knowing because we so often hear of the potential DOE-related advantages of ARBs over the older, less expensive, and less often promoted ACE inhibitors.
BOTTOM LINE
Despite a relatively low dose of 10 mg given once a day, enalapril (Vasotec) was at least as effective as telmisartan (Micardis) and showed a trend toward greater benefit in preventing decline in glomerular filtration rate. Although this study measured a disease-oriented endpoint, its results are consistent with the body of literature that supports the less expensive angiotensin-converting enzyme (ACE) inhibitors as the drug of choice over angiotensin receptor blockers (ARBs). (LOE=1b)
