Medical treatment of Marfan syndrome: a time for change.
It is accepted practice to prescribe beta-blockers in order to retard aortic dilatation and prevent aortic dissection and rupture in patients with Marfan syndrome. A critical review of the published pharmacological studies shows this practice to be based on limited evidence. The data from small clinical and experimental studies with surrogate end points suggest greater potential benefit from alternative drug regimens, and a recent experimental study showed that losartan may interrupt the mechanism of disease as well as deal with its functional consequences. It is now essential to perform large, collaborative, randomised controlled trials with clinical end points of new treatments in Marfan syndrome.
Williams
A
A
Wales Heart Research Institute, Wales College of Medicine, Cardiff CF14 4XN, UK. awilliams97@supanet.com.
Davies
S
S
Stuart
A G
AG
Wilson
D G
DG
Fraser
A G
AG
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D006801:Humans; D019808:Losartan / Q000627:therapeutic use; D008382:Marfan Syndrome / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D002317:Cardiovascular Agents; D019808:Losartan