title: Angiotensin-converting enzyme inhibitors and motor neuron disease: An unconfirmed association.
abstract: To investigate the association between angiotensin converting enzyme inhibitors (ACEIs), angiotensin II receptors blockers (ARBs) and motor neuron disease (MND).
  
  
  
  This is a population-based nested case-control study. Data were obtained from a population registry and the administrative database of the Lombardy Region (Northern Italy) from 2000 through 2010. Included were 1,200 patients with newly diagnosed MND/ALS and 120,000 controls, randomly selected from the same population and matched for gender, age and area of residence. Exposure to ACEIs or ARBs was quantified using defined daily doses (DDDs). Cumulative DDD (cDDD) was estimated as the sum of dispensed DDDs in the preceding 5 years, excluding 1 year before the MND/ALS diagnosis. Overall exposure, levels of exposure, and individual drugs were all assessed. Subgroup analyses were performed according to age, sex, ALS and ACEI-ARB association.
  
  
  
  There was no significant association between MND/ALS and antecedent use of ACEIs or ARBs. Data were confirmed in multivariable models and in subgroups.
  
  
  
  A protective role of ACEIs and ARBs in MND was not confirmed. Differences with a previous report (showing an inverse association between ACEIs and ALS) can be explained by different genetic background, dietary habits and susceptibility to environmental exposures, including drugs.
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Franchi
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Elisa
authors.initials: E
authors.lastname: Bianchi
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Pupillo
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Marco
authors.initials: M
authors.lastname: Poloni
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Nobili
authors.affiliation: b Regional Health Ministry, Lombardy Region , Milan , Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Fortino
authors.affiliation: b Regional Health Ministry, Lombardy Region , Milan , Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Bortolotti
authors.affiliation: b Regional Health Ministry, Lombardy Region , Milan , Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Merlino
authors.affiliation: a Department of Neuroscience , IRCCS - Istituto di Ricerche Farmacologiche "Mario Negri" , Milan , Italy and.
authors.forename: Ettore
authors.initials: E
authors.lastname: Beghi
mesh_terms: D000368:Aged; D057912:Angiotensin II Type 2 Receptor Blockers / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D016022:Case-Control Studies; D018672:Community Health Planning; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D057912:Angiotensin II Type 2 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: Angiotens in Receptor Blockers (ARB); Angiotensin-Converting Enzyme Inhibitors; Drugs; administrative data; motor neuron disease