Angiotensin Ⅱ receptor blockers and gastrointestinal adverse events of resembling sprue-like enteropathy:a systematic review

作     者：Ayesha Kamal Christopher Fain Angela Park Peiqi Wang Eduardo Gonzalez-Velez Daniel A.Leffler Susan M.Hutfless 

作者机构：Department of MedicineDivision of GastroenterologyJohns Hopkins UniversityBaltimoreMDUSA Johns HopkinsDepartment of Surgery and Surgical SciencesJohns Hopkins UniversityBaltimoreMDUSA Division of GastroenterologyBeth Israel Deaconess Medical CenterBostonMAUSA Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2019年第7卷第3期

页      码：162-167,I0001页

摘      要：Background:Olmesartan,an angiotensin Ⅱ receptor blocker(ARB),is associated with gastrointestinal symptoms resembling sprue-like *** have proposed that enteropathy may be a class effect rather than *** performed a systematic review to identify literature of sprue-like enteropathy for all ***:Case reports,case series and comparative studies of ARBs were searched on PubMed and Embase databases through 21 November 2018 and then ***:A total of 82 case reports and case series as well as 5 comparative studies,including 248 cases,were selected and *** ARBs listed in the case reports were olmesartan(233 users;94.0%),telmisartan(5 users;2.0%),irbesartan(4 users;1.6%),valsartan(3 users;1.2%),losartan(2 users;0.8%)and eprosartan(1 user;0.4%).The periods between ARB initiation and onset of symptoms ranged from 2 weeks to 13 *** results were reported in 218 cases,in which 201 cases(92.2%)were villous atrophy and 131 cases(60.1%)were intraepithelial *** leucocyte antigen(HLA)testing was performed in 147 patients,among whom 105(71.4%)had HLA-DQ2 or HLA-DQ8 *** antibodies were tested in 169 patients,among whom 167(98.8%)showed negative *** exclusion from the diet failed to relieve symptoms of enteropathy in 127(97.7%)of 130 patients with *** remission of symptoms after discontinuation of ARB was reported in 233(97.4%)of the 239 patients with *** cases(2.8%)reported recurrence of symptoms after restarting olmesartan;rechallenge was not reported for the non-olmesartan *** retrospective studies conducted worldwide had inconsistent study designs(*** in periods of study and case definition)and ***:Although enteropathy is rare,clinicians should remain vigilant of this potential adverse event even years after medication initiation.

主 题 词：angiotensinⅡreceptor blockers olmesartan enteropathy diarrhea 

学科分类：1002[医学-临床医学类] 100201[100201] 10[医学] 

D　O　I：10.1093/gastro/goz019

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