title: Moexipril for treatment of primary biliary cirrhosis in patients with an incomplete response to ursodeoxycholic acid.
abstract: Blockade of angiotensin II synthesis attenuates hepatic fibrosis in different experimental models of chronic liver injury. We evaluated the safety and efficacy of moexipril, an angiotensin-converting enzyme inhibitor, in patients with primary biliary cirrhosis (PBC) who have had a suboptimal response to ursodeoxycholic acid (UDCA). Twenty PBC patients on UDCA (13-15 mg/kg/day) therapy with an elevation of serum alkaline phosphatase at least twice the upper limit of normal were treated with oral moexipril 15 mg/day for one year. No significant changes in serum alkaline phosphatase (379 +/- 32 vs. 379 +/- 51), bilirubin (0.8 +/- 0.1 vs. 0.9 +/- 0.1), aspartate aminotransferase (60 +/- 8 vs. 63 +/- 9), and Mayo risk score (3.55 +/- 0.2 vs. 3.62 +/- 0.2) was associated with the treatment. Fatigue and health-related quality of life scores during treatment demonstrated a trend toward improvement. Moexipril was not clinically beneficial to PBC patients responding suboptimally to UDCA.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN 55905, USA. phunchia@yahoo.com
authors.forename: Phunchai
authors.initials: P
authors.lastname: Charatcharoenwitthaya
authors.forename: Jayant A
authors.initials: JA
authors.lastname: Talwalkar
authors.forename: Paul
authors.initials: P
authors.lastname: Angulo
authors.forename: Andrea A
authors.initials: AA
authors.lastname: Gossard
authors.forename: Jill C
authors.initials: JC
authors.lastname: Keach
authors.forename: Janice L
authors.initials: JL
authors.lastname: Petz
authors.forename: Roberta A
authors.initials: RA
authors.lastname: Jorgensen
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lindor
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002756:Cholagogues and Choleretics; D003692:Delayed-Action Preparations; D044005:Tetrahydroisoquinolines; D014580:Ursodeoxycholic Acid; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase; D001663:Bilirubin; C058302:moexipril