Combination therapy an ACE inhibitor and an angiotensin receptor blocker for IgA nephropathy: a meta-analysis
Version of Record online: 19 SEP 2012
© 2012 Blackwell Publishing Ltd
International Journal of Clinical Practice
Volume 66, Issue 10, pages 917–923, October 2012
How to Cite
Cheng, J., Zhang, X., Tian, J., Li, Q. and Chen, J. (2012), Combination therapy an ACE inhibitor and an angiotensin receptor blocker for IgA nephropathy: a meta-analysis. International Journal of Clinical Practice, 66: 917–923. doi: 10.1111/j.1742-1241.2012.02970.x
Linked Comment: Ng et al. Int J Clin Pract 2012; 66: 913-5.
- Issue online: 19 SEP 2012
- Version of Record online: 19 SEP 2012
Objective: The pathogenesis of IgA nephropathy (IgAN) is still unknown. Combination therapy with angiotensin-converting enzyme inhibitors (ACEIs) plus angiotensin receptor blockers (ARBs) might provide more benefits to IgAN patients. We conducted a systematic review to assess the efficacy of combination therapy for IgAN.
Methods: The MEDLINE, EMBASE, the Cochrane Library and article reference lists were searched for randomised clinical trials (RCTs) which involved combination therapy ACEI plus ARB in only one arm. A meta-analysis was performed on the outcomes of proteinuria and renal function in IgAN patients.
Results: Six RCTs involving 109 patients were included in the review. Combined treatment with ACEI plus ARB was more effective than with ACEI/ARB alone for reducing daily proteinuria. This did not translate into an improvement in GFR. Patients receiving ACEI plus ARB therapy did not have an increased risk of hyperkalemia.
Conclusions: The current cumulative evidence suggests that combination therapy ACEI plus ARB may provide more benefits to IgAN patients for reducing daily proteinuria. Long-term effects of these agents on renal outcomes, and safety need to be established.