Why the study?
Do angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)?
Do angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) improve outcomes in patients with nonalcoholic fatty liver disease (NAFLD)?
While preclinical data suggest ACE-I and ARBs may be beneficial in NAFLD, current clinical evidence is insufficient and requires confirmation through large RCTs.
Nonalcoholic fatty liver disease (NAFLD) is the commonest liver disease in Western countries. Treatment of NAFLD is currently based on lifestyle measures and no effective pharmacologic treatment is available so far. Emerging evidence, mainly from animal studies, suggests that the renin-angiotensin-aldosterone system may be of major importance in the pathogenesis of NAFLD and indicates that angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin receptor blockers (ARBs) as a potentially useful therapeutic approach. However, data from human studies are limited and contradictory. In addition, there are few randomized controlled trials (RCTs) on the effects of ACE-I or ARB in patients with NAFLD and most data are from retrospective studies, pilot prospective studies and post hoc analyses of clinical trials. Accordingly, more and larger RCTs are needed to directly assess the effectiveness of ACE-I and ARBs in NAFLD.
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Paschos et al. (2012) studied this question.
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