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An evidence‐based systematic review of the off‐label uses of lisinopril
Author(s) -
SadatEbrahimi SeyyedReza,
Parnianfard Neda,
Vahed Nafiseh,
Babaei Hossein,
Ghojazadeh Morteza,
Tang Sydney,
Azarpazhooh Amir
Publication year - 2018
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.13705
Subject(s) - lisinopril , medicine , urology , cochrane library , enalapril , renal function , randomized controlled trial , angiotensin converting enzyme , blood pressure
Aims Lisinopril is an angiotensin‐converting‐enzyme inhibitor that is largely administered for off‐label uses. This study aims to provide a comprehensive review of off‐label uses of lisinopril to aid physicians to make evidence‐based decisions. Methods The following bibliographic databases were searched from inception up to 30 March 2017: PubMed, EMBASE, the Cochrane Library, Cochrane Central Register of Controlled Trials, Scopus, Ovid and Proquest. This systematic review sought all randomized trials conducted on adult individuals comparing lisinopril on its off‐label uses with alternative drugs or placebos and reported direct or alternative clinical outcomes. Risk of bias assessment by using the Cochrane Collaboration risk‐of‐bias tool and quality evaluation took place. Results Included studies demonstrated significant positive effects of lisinopril on proteinuric kidney disease; however, lisinopril caused a slight reduction of glomerular filtration rate (GFR) especially for patients with GFR < 90 ml min –1 . Lisinopril offered better outcomes in comparison to other standard treatments of diabetic nephropathy. Other studies showed positive effects of lisinopril for migraine, prevention of diabetes, myocardial fibrosis, mitral valve regurgitation, cardiomyopathy in patients with Duchenne muscular dystrophy, oligospermia and infertility, and diabetic retinopathy. Conversely, the studies reported that lisinopril was ineffective for five other off‐label uses. Conclusions The identified studies showed that lisinopril was highly effective for proteinuric kidney disease with a minor but inconsiderable decrease in GFR. Positive effects of lisinopril were demonstrated in seven other off‐label uses; however, lisinopril cannot be recommended as the first choice for these until further clinical trials confirm these positive effects.