Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative LEEP Trial.

dc.contributor.author

Wise, Robert A

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Holbrook, Janet T

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Brown, Robert H

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Criner, Gerard J

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Dransfield, Mark T

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He, Jiaxian

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Henderson, Robert J

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Kaminsky, David A

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Kaner, Robert J

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Lazarus, Stephen C

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Make, Barry J

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McCormack, Meredith C

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Neptune, Enid R

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Que, Loretta G

dc.date.accessioned

2022-07-01T13:23:09Z

dc.date.available

2022-07-01T13:23:09Z

dc.date.issued

2022-06

dc.date.updated

2022-07-01T13:23:08Z

dc.description.abstract

Rationale

There are no pharmacologic agents that modify emphysema progression in patients with chronic obstructive pulmonary disease (COPD).

Objective

Evaluate the efficacy of losartan, an angiotensin receptor blocker (ARB), to reduce emphysema progression.

Methods

The trial was a multicenter randomized placebo-controlled trial, conducted between May 2017 and January 2021. Eligible participants were age ≥40, had moderate to severe airflow obstruction, ≥10 pack-years smoking, mild-moderate emphysema on high-resolution computed tomography (HRCT), and no medical indication for or intolerance of ARBs. Treatment with losartan, 100 mg daily, or matching placebo (1:1) was randomly assigned. The primary outcome was emphysema progression on HRCT over 48 weeks. Secondary outcomes included St George's Respiratory Questionnaire (SGRQ), modified Medical Research Council dyspnea scale, COPD Assessment Test, Physical Function-Short Form 20a (PROMIS 20a).

Results

220 participants were enrolled; 58% were men, 19% were African American; and 24% current smokers. The medians (interquartile ranges) for age were as 65 (61, 73) years, and 48 (36, 59) for percent predicted FEV1 post-bronchodilator. The mean (95% confidence interval) percent emphysema progression was 1.35% (0.67, 2.03) in the losartan group vs 0.66% (0.09, 1.23) in placebo (P = NS).

Conclusions

Losartan did not prevent emphysema progression in people with COPD with mild-moderate emphysema. Clinical trial registration available at www.

Clinicaltrials

gov, ID: NCT02696564.
dc.identifier.issn

1073-449X

dc.identifier.issn

1535-4970

dc.identifier.uri

https://hdl.handle.net/10161/25419

dc.language

eng

dc.publisher

American Thoracic Society

dc.relation.ispartof

American journal of respiratory and critical care medicine

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10.1164/rccm.202201-0206oc

dc.subject

American Lung Association Airways Clinical Research Centers and Pulmonary Trials Cooperative

dc.title

Clinical Trial of Losartan for Pulmonary Emphysema: Pulmonary Trials Cooperative LEEP Trial.

dc.type

Journal article

pubs.organisational-group

Duke

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School of Medicine

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Clinical Science Departments

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Medicine

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Medicine, Pulmonary, Allergy, and Critical Care Medicine

pubs.publication-status

Published

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