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Long-term exposure to ACE inhibitors may reduce risk for ALS
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Researchers found a dose-dependent inverse association between the use of ACE inhibitors and risk for developing amyotrophic lateral sclerosis.
The link had previously been observed in animal studies but had yet to be analyzed in humans, according to the study background.
Feng-Cheng Lin, MD, and colleagues performed a case-control study comparing 729 patients in Taiwan with newly diagnosed amyotrophic lateral sclerosis (ALS) and a severely disabling disease certificate between 2002 and 2008 with 14,580 controls matched according to age, sex, residence and insurance premiums.
They analyzed use of ACE inhibitors via a conditional logistic regression model controlling for the use of other antihypertensive medications, aspirin, steroids and nonsteroidal anti-inflammatory drugs, along with Charlson comorbidity index score, duration of hospital stay and number of outpatient visits. Exposure to ACE inhibitors was defined as the cumulative defined daily dose, estimated as the sum of the dispensed defined daily dose of the drug. This exposure was compared with the risk for ALS.
Lin, from the department of neurology at Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, and colleagues found that compared with those not using ACE inhibitors, patients who had been prescribed ACE inhibitors with a cumulative defined daily dose <449.5 in 4 years had no difference in risk for ALS (adjusted OR=0.83; 95% CI, 0.65-1.07), but those prescribed ACE inhibitors with a cumulative defined daily dose >449.5 in 4 years had decreased risk (adjusted OR=0.43; 95% CI, 0.26-0.72).
The observed association was strongest among men aged at least 55 years, Lin and colleagues wrote.
“Our study suggests that [ACE inhibitor] use has a potential role in the prevention of ALS,” they wrote. “This was an observational population-based study; hence, more animal and clinical studies are required to assess the possibility of using [ACE inhibitors] for treating ALS.”
Disclosure: The study was supported by the Ching-Ling Foundation of Taipei Veterans General Hospital. The researchers report no relevant financial disclosures.
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