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  • Combination ACE inhibitor and angiotensin receptor blocker therapy was better than monotherapy in non-diabetic renal disease

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Therapeutics
Combination ACE inhibitor and angiotensin receptor blocker therapy was better than monotherapy in non-diabetic renal disease

https://doi.org/10.1136/ebm.8.5.143

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    (2003) Lancet 361, 117. Nakao N, Yoshimura A, Morita H, et al.. Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial.. ;. :. –24.
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 QUESTION: In patients with non-diabetic renal disease, what is the effectiveness of the angiotensin II receptor blocker (ARB) losartan, the angiotensin converting enzyme (ACE) inhibitor trandolapril, or the 2 drugs combined for delaying disease progression?

    Design

    Randomised (unclear allocation concealment*), blinded (clinicians, patients, data collectors, and monitoring committee),* controlled trial with 3 years of follow up.

    Setting

    Hospital outpatient renal clinic serving 3 cities in Japan.

    Patients

    301 patients 18–70 years of age who had chronic non-diabetic renal insufficiency, persistent proteinuria, and no history of allergic reaction to drugs. Exclusion criteria included immediate need for renal replacement therapy; need for corticosteroids, non-steroidal anti-inflammatory drugs, or immunosuppressive drugs; proteinuria >10 g/day and hypoalbuminaemia <28 g/l; other serious disease; and pregnancy or breastfeeding. 263 patients …

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