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Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial.

Publication ,  Journal Article
Wise, RA; Holbrook, JT; Brown, RH; Criner, GJ; Dransfield, MT; He, J; Henderson, RJ; Kaminsky, DA; Kaner, RJ; Lazarus, SC; Make, BJ; Que, LG ...
Published in: Am J Respir Crit Care Med
October 1, 2022

Rationale: There are no pharmacologic agents that modify emphysema progression in patients with chronic obstructive pulmonary disease (COPD). Objectives: To evaluate the efficacy of losartan, an angiotensin receptor blocker, to reduce emphysema progression. Methods: The trial was a multicenter, randomized, placebo-controlled trial conducted between May 2017 and January 2021. Eligible participants were aged ⩾40 years, had moderate to severe airflow obstruction, ⩾10 pack-years of smoking, mild-moderate emphysema on high-resolution computed tomography, and no medical indication for or intolerance of angiotensin receptor blockers. Treatment with losartan 100 mg daily or matching placebo (1:1) was randomly assigned. The primary outcome was emphysema progression on high-resolution computed tomography over 48 weeks. Secondary outcomes included the St George's Respiratory Questionnaire, the modified Medical Research Council dyspnea scale, the COPD Assessment Test, and the Physical Function-Short Form 20a. Measurements and Main Results: A total of 220 participants were enrolled; 58% were men, 19% were African American, and 24% were current smokers. The medians (interquartile ranges) for age were 65 (61-73) years and 48 (36-59) for percent predicted FEV1 after bronchodilator use. The mean (95% confidence interval) percentage emphysema progression was 1.35% (0.67-2.03) in the losartan group versus 0.66% (0.09-1.23) in the placebo group (P = NS). Conclusions: Losartan did not prevent emphysema progression in people with COPD with mild-moderate emphysema. Clinical trial registered with www.clinicaltrials.gov (NCT02696564).

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Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

October 1, 2022

Volume

206

Issue

7

Start / End Page

838 / 845

Location

United States

Related Subject Headings

  • Respiratory System
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Male
  • Losartan
  • Humans
  • Forced Expiratory Volume
  • Female
  • Emphysema
  • Disease Progression
 

Citation

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Wise, R. A., Holbrook, J. T., Brown, R. H., Criner, G. J., Dransfield, M. T., He, J., … Que, L. G. (2022). Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial. Am J Respir Crit Care Med, 206(7), 838–845. https://doi.org/10.1164/rccm.202201-0206OC
Wise, Robert A., Janet T. Holbrook, Robert H. Brown, Gerard J. Criner, Mark T. Dransfield, Jiaxian He, Robert J. Henderson, et al. “Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial.Am J Respir Crit Care Med 206, no. 7 (October 1, 2022): 838–45. https://doi.org/10.1164/rccm.202201-0206OC.
Wise RA, Holbrook JT, Brown RH, Criner GJ, Dransfield MT, He J, et al. Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial. Am J Respir Crit Care Med. 2022 Oct 1;206(7):838–45.
Wise, Robert A., et al. “Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial.Am J Respir Crit Care Med, vol. 206, no. 7, Oct. 2022, pp. 838–45. Pubmed, doi:10.1164/rccm.202201-0206OC.
Wise RA, Holbrook JT, Brown RH, Criner GJ, Dransfield MT, He J, Henderson RJ, Kaminsky DA, Kaner RJ, Lazarus SC, Make BJ, McCormack MC, Neptune ER, Que LG. Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative Losartan Effects on Emphysema Progression Clinical Trial. Am J Respir Crit Care Med. 2022 Oct 1;206(7):838–845.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

October 1, 2022

Volume

206

Issue

7

Start / End Page

838 / 845

Location

United States

Related Subject Headings

  • Respiratory System
  • Pulmonary Emphysema
  • Pulmonary Disease, Chronic Obstructive
  • Male
  • Losartan
  • Humans
  • Forced Expiratory Volume
  • Female
  • Emphysema
  • Disease Progression