Key result
Atenolol-losartan therapy improves aortic root dilatation and capsular rings stabilize lens subluxation in Marfan syndrome.
Why the study?
Due to multisystem involvement advancing with age, the clinical presentation and management of Marfan's syndrome and associated pathologies require cautious focus.
Do medical, psychological, and surgical interventions improve clinical and surrogate outcomes in patients with Marfan's syndrome?
Systematic Review
Do medical, psychological, and surgical interventions improve clinical and surrogate outcomes in patients with Marfan's syndrome?
This systematic review highlights that combining atenolol and losartan may be beneficial for managing aortic root dilatation in Marfan's syndrome, while Cionni modified capsular tension rings are effective for lens subluxation.
Answers are grounded in this paper and cite their sources.
Supports combined strategies for aortic and lens complications in Marfan syndrome; extends evidence from 8 trials.
<ns4:p><ns4:bold>Background</ns4:bold></ns4:p><ns4:p> Marfan’s syndrome (MFS) is an autosomal dominant hereditary connective tissue disorder associated with numerous skeletal, ocular, cardiovascular, and respiratory pathologies which advance with age. Following multiple system involvement of body, the clinical presentation and management of MFS with associated pathologies are an area of cautious focus. Therefore, this review focused on highlighting various management options that are currently being supported for the MFS patients.</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Methodology</ns4:bold></ns4:p><ns4:p> The search methodology involved randomized controlled trials (RCTs) published between 2018 to 2022 from PubMed and Google Scholar databases. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) were followed for reviewing the data extracted following the inclusion and exclusion criteria using the keywords “Marfan’s Syndrome”, “Irbesartan”, “Aortic Dilatation”, “Atenolol”, and “Lens Subluxation.”</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Results</ns4:bold></ns4:p><ns4:p> A total of eight articles were reviewed for the preferred distribution of population and the management options followed in the studies consisting of medical, psychological, and surgical interventions. Also, the associated pathologies related to MFS patients were analysed and found to have significant impact on health-related quality of life of MFS patients.</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Conclusions</ns4:bold></ns4:p><ns4:p> The review concluded that a combination of drugs atenolol, a β-blocker, and losartan which is an angiotensin receptor blocker, is beneficial in case of aortic root dilatation and higher aortic root stiffness. Additionally, ADRB1 testing may determine patients that are more likely to respond therapeutically to atenolol in comparison to losartan. Cionni modified capsular tension rings (MCTR) have been acknowledged as an effective device for delivering good capsular bag stabilization in cases of lens subluxation in MFS patients.</ns4:p>
No takes yet. Share an insight, caveat, or question.
Pashine et al. (2023) conducted a systematic review in Marfan's syndrome. Medical, psychological, and surgical interventions (including atenolol, losartan, and Cionni modified capsular tension rings) was evaluated. Combined atenolol and losartan therapy benefits aortic root dilatation, and Cionni modified capsular tension rings stabilize lens subluxation in Marfan's syndrome across 8 reviewed trials.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: