To print: Select File and then Print from your browser's menu --------------------------------------------------------------------------------------- Title: ACE Inhibitors, but Not ARBs, Associated with Angio-Oedema in Kidney Transplant Recipients on mTor Therapy: Presented at ATC URL: http://www.pslgroup.com/dg/22320A.htm Doctor's Guide June 6, 2008
By Thomas S. May TORONTO -- June 6, 2008 -- Angio-oedema, a potentially life-threatening swelling of the face, lips, mouth, and throat, occurs in up to 5% of kidney transplant recipients who take angiotensin-converting enzyme (ACE) inhibitors while receiving treatment with mammalian target of rapamycin (mTOR) inhibition. The findings, from an analysis of an electronic patient database at Charité University Hospital, Berlin, Germany, was presented in a poster session here on June 2 at the 2008 American Transplant Congress (ATC). Michael Duerr, MD, Department of Internal Medicine, Charité University Hospital, and colleagues systematically screened their database for all cases of angio-oedema in patients receiving mTOR-inhibitor therapy. They identified 112 patients receiving both ACE inhibition and mTOR inhibition (with a total of 169 treatment years) after kidney transplantation. The investigators also identified 73 kidney transplant recipients who had received mTOR inhibition in combination with an angiotensin-receptor blocker (ARB). The researchers found that 4.5% of patients who received both an ACE inhibitor and mTOR inhibitor developed angio-oedema after a mean of 98 days, whereas none of the kidney transplant recipients on combined mTOR inhibition and ARB developed angio-oedema (P < .05). All patients who developed angio-oedema recovered rapidly after stopping their ACE inhibitor (n = 6) and receiving steroid treatment when necessary (n = 3). After the resolution of angio-oedema, treatment with ARBs was initiated in 4 of these patients, and the condition did not reoccur in any of these patients. These results show that angio-oedema occurs with an incidence of approximately 5% under combined therapy with an mTOR inhibitor and ACE inhibitor but does not occur with mTOR inhibitors and ARBs, the researchers concluded. In light of these data, clinicians should give preferred consideration to using ARBs instead of ACE inhibitors in combination with mTOR inhibitors, said Dr. Duerr. He also noted that angio-oedema seemed to take an atypical course in kidney transplant recipients compared with other patients "in terms of relatively diminished symptoms. We think this may have been due to a modified allergy response because of a suppressed immune system," Dr. Duerr explained. [Presentation title: Increased Incidence of Angioedema Under Combined Therapy With mTOR and ACE-Inhibitors in Kidney Transplant Recipients. Abstract 1300] --------------------------------------------------------------------------------------------- Copyright © 1999 P\S\L Consulting Group Inc. All rights reserved. Republication or redistribution of P\S\L content is expressly prohibited without the prior written consent of P\S\L. P\S\L shall not be liable for any errors, omissions or delays in this content or any other content on its sites, newsletters or other publications, nor for any decisions or actions taken in reliance on such content. --------------------------------------------------------------------------------------------- This news story was printed from *Doctor's Guide to the Internet* located at http://www.docguide.com --------------------------------------------------------------------------------------- Return to News Story Page This site is maintained by webmaster@pslgroup.com Please contact us with any comments, problems or bugs. All contents Copyright (c) 1998 P\S\L Consulting Group Inc. All rights reserved.