Chest

Sarcoidosis: How ACEI and ARBs influence the course of illness

October 29, 2024

Angiotensin-converting enzyme inhibitor (ACEI) prescriptions were linked to higher mortality risks, worse cardio-pulmonary outcomes, and higher sepsis rates in sarcoidosis patients, compared with angiotensin receptor blockers (ARBs), according to this database study.

• Background: Angiotensin-converting enzyme (ACE) is expressed by healthy lung tissue. Many patients with the multi-system inflammatory condition sarcoidosis show elevated serum ACE levels, but its use as a biomarker is limited by poor sensitivity and specificity. Case reports have suggested possible benefits of ACE inhibition, for example, in improving skin manifestations. Researchers sought to correlate use of ACEI and ARB drugs on the course of the illness.
• Records from a multicenter database on adults aged 18 and older being treated for sarcoidosis were examined for prescriptions of ACEI or ARB drugs since their diagnosis. Cohorts were matched for clinical covariates. Outcomes included mortality, cardio-respiratory outcomes, and sepsis rates.
• Results: Mortality risk was increased in sarcoidosis prescribed ACEI vs. those prescribed ARB drugs. Similarly, those prescribed ACEI drugs had showed worse cardio-respiratory outcomes and higher sepsis rates vs. the ARB cohort.

Source:

Fares J, et al. (2024, September 21). Chest. Mortality and Health Outcomes Among Patients With Sarcoidosis Treated With Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers. https://pubmed.ncbi.nlm.nih.gov/39313185/