This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Raes, A. Articles by Vande Walle, J. Search for Related Content PubMed PubMed Citation Articles by Raes, A. Articles by Vande Walle, J. Social Bookmarking                         What's this?

Review: Lisinopril in paediatric medicine: a retrospective chart review of long-term treatment in children

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium, ann.raes@ ugent.be

Franciska Malfait

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium

Sarah Van Aken

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium

Annick France

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium

Raymond Donckerwolcke

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium

Johan Vande Walle

Department of Paediatric Nephrology University Hospital, De Pintelaan 185, 9000 Gent, Belgium

Objective. To investigate the antihypertensive efficacy, dosing, tolerability and effects on growth of lisinopril (off label-use) in paediatric patients during long-term treatment.

Design. We conducted a retrospective analysis of data from 123 patients treated with lisinopril in a paediatric nephrology clinic over a 9.3-year period. Patients were categorised by age group and predominant clinical diagnosis: hypertension (n=59), renal parenchymal disease (n=27), diabetes mellitus (n=33) and miscellaneous (n=4).

Results. The vast majority were Caucasian (93%) and boys (66%). Mean duration of treatment was 2.0 years. Age at start of treatment ranged from two months to 17.7 years. Mean lisinopril starting and final doses were 0.105 mg/kg/day for hypertensive patients and 0.108 mg/kg/day for patients with renal disease, respectively. The most common adverse event was hypotension (8.6% of the patients). Haematology and serum biochemistry profiles were unaffected by lisinopril. Growth was not different from data recorded by Belgian population studies. In 29 of the 47 hypertensive patients who received lisinopril monotherapy, comparing blood pressure (BP) at baseline and after six months' treatment, mean reductions in systolic/diastolic BP were 19/18 mmHg.

Conclusions. Lisinopril was well tolerated in paediatric patients. Doses of 0.1 mg/kg/day produced clinically significant BP reduction in hypertensive patients.

Key Words: ACE inhibition • lisinopril • paediatrics • hypertension • tolerability

References

• Conroy S., Choonara I., Impicciatore P. et al. Survey of unlicensed and off label drug use in paediatric wards in European countries. European Network for Drug Investigation in Children. BMJ 2000;320(7227):79-82.
• Sutcliffe AG Prescribing medicines for children. BMJ 1999;319(7202):70-1.[Free Full Text]
• Garg R., Yusuf S. Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials. JAMA 1995;273:1450-6.[Abstract/Free Full Text]
• Indications for ACE inhibitors in the early treatment of acute myocardial infarction: systematic overview of individual data from 100,000 patients in randomized trials. ACE Inhibitor Myocardial Infarction Collaborative Group. Circulation 1998;97:2202-12.[Abstract/Free Full Text]
• Randomised placebo-controlled trial of lisinopril in normotensive patients with insulin-dependent diabetes and normoalbuminuria or microalbuminuria. The EUCLID Study Group. Lancet 1997;349:1787-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Raes A., Van Aken S., Vande Walle J., Matthys D., Craen M. Are renal hypertrophy and renal functional abnormalities reversible in children with IDDM? Pediat Nephr 1997;11:C38.
• Van Aken S., Raes A., Vande Walle J., Matthys D., Craen M. Renal hypertrophy is reversible with long term lisinopril therapy in children with Type 1 diabetes mellitus. Diabetologia 1999;42(suppl 1):A10.
• The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004;114(suppl 2):555-76.[Free Full Text]
• Vande Walle J., Van Aken S., Raes A., France A., Malfliet F., Craen M. Monitoring and titrating lisinopril therapy in children. 32nd Annual meeting of the American society of
• nephrology Miami Beach, Florida;1999:p135A
• . Hauspie RC, Wachholder A., Vercauteren M. Reference values of the height and weight growth and growth rate of Belgian boys and girls 3-18 years of age. Arch Fr Pediatr 1993;50:763-9.[Web of Science][Medline] [Order article via Infotrieve]
• FDA. Best Pharmaceuticals for Children Act. FDA Regulation January 4, 2002. Available at http://www.fda.gov/opacom/laws/pharmkids/contents.html. Accessed October 2005.
• European legislation. EEC 1768/92, directive 2001/83/EC and regulation EC 726. Brussels: EU, 2004.
• Doyle AE Role of angiotensin-converting enzyme inhibitors in preventing or reducing end-organ damage in hypertension. J Cardiovasc Pharmacol 1992;19(suppl 5):S21-S27.
• The sixth report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1997;157:2413-46.[Abstract/Free Full Text]
• Soffer B., Zhang Z., Miller K., Vogt BA, Shahinfar S. A double-blind, placebo-controlled, dose-response study of the effectiveness and safety of lisinopril for children with hypertension. Am J Hypertens 2003;16:795-800.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Diez J., Laviades C. Insulin-like growth factor-1 and cardiac mass in essential hypertension: comparative effects of captopril, lisinopril and quinapril. J Hypertens Suppl 1994;12(4):S31-S36.[Medline] [Order article via Infotrieve]
• Flynn JT, Mottes TA, Brophy PD et al. Intravenous nicardipine for treatment of severe hypertension in children. J Pediatr 2001;139(1):38-43.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Flynn JT, Smoyer WE, Bunchman TE Treatment of hypertensive children with amlodipine. Am J Hypertens 2000;13:1061-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Silverstein DM, Champoux E., Aviles DH, Vehaskari VM Treatment of primary and secondary hypertension in children. Pediatr Nephrol 2006;21:820-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Flynn JT Efficacy and safety of prolonged amlodipine treatment in hypertensive children. Pediatr Nephrol 2005;20:631-5.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Flynn JT, Newburger JW, Daniels SR, Sanders SP, Portman RJ, Hogg RJ A randomized, placebo-controlled trial of amlodipine in children with hypertension. J Pediatr 2004;145:353-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

Journal of Renin-Angiotensin-Aldosterone System, Vol. 8, No. 1, 3-12 (2007)
DOI: 10.3317/jraas.2007.004


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This Article Abstract Free Full Text (Free PDF) Free Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Raes, A. Articles by Vande Walle, J. Search for Related Content PubMed PubMed Citation Articles by Raes, A. Articles by Vande Walle, J. Social Bookmarking                         What's this?