June 1, 2006Lupus
The renin-angiotensin system in lupus: physiology, genes and practice, in animals and humans
Why the study?
Do ACE inhibitors and ARBs improve renal outcomes and survival in animal models and patients with lupus?
Population
Autoimmune-prone MRL/lpr mice and human patients with treatment-refractory lupus nephritis or pauci-immune…
Design
Review
Authors
Discussion
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Member takes
Implication
May support ACE inhibitor consideration in refractory lupus nephritis; leaves open need for RCTs to confirm renal and survival benefits.
Structured PICO
Do ACE inhibitors and ARBs improve renal outcomes and survival in animal models and patients with lupus?
P
Population
Autoimmune-prone MRL/lpr mice and human patients with treatment-refractory lupus nephritis or pauci-immune vasculitis
I
Intervention
Angiotensin-converting-enzyme (ACE) inhibitors and Angiotensin receptor blockers (ARBs)
O
Outcome
Survival, proteinuria, and renal histopathologic damage
While ACE inhibitors and ARBs show promise in reducing proteinuria and renal damage in lupus models and limited human studies, their masking effect on proteinuria requires careful monitoring.
Limitations
- Data on the role of this intervention in lupus is limited
- Masking effect of ACE-inhibitors on proteinuria may lead to missed exacerbations of lupus nephritis
Cite This Study
Teplitsky et al. (2006) studied this question.