An evidence-based systematic review of the off-label uses of lisinopril.

Seyyed-Reza Sadat-Ebrahimi, Neda Parnianfard, Nafiseh Vahed, Hossein Babaei, Morteza Ghojazadeh, Sydney Tang, Amir Azarpazhooh

British journal of clinical pharmacology 2018 Nov

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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. 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. 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. 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. © 2018 The British Pharmacological Society.

Citation

Seyyed-Reza Sadat-Ebrahimi, Neda Parnianfard, Nafiseh Vahed, Hossein Babaei, Morteza Ghojazadeh, Sydney Tang, Amir Azarpazhooh. An evidence-based systematic review of the off-label uses of lisinopril. British journal of clinical pharmacology. 2018 Nov;84(11):2502-2521