MUST READ! COVID-19 Warnings: High Blood Pressure Drug Captopril Associated With Pulmonary Adverse Reactions In COVID-19 Patients With Diabetes
: A US based study involving researchers from University of Missouri Kansas City School of Pharmacy, Kansas State University and North Carolina State University has found that the high blood pressure drug Captopril to be associated with a higher rate of pulmonary adverse reactions in patients with diabetes than that of other ACE inhibitors or angiotensin receptor blockers (ARBs).
The researchers warn that Captopril might therefore not be the best choice for patients with diabetes and COVID-19.
Captopril is the only currently available ACE inhibitor belonging to the sulfhydryl-containing class and may explain the higher incidence of adverse drug effects observed, according to the researchers.
Captopril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure, protect the kidneys from harm due to diabetes, and to improve survival after a heart attack.
Captopril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily. It is sold under the brand name Capoten.
The research team lead by Assistant Professor Dr Emma G Stafford evaluated the prevalence of pulmonary adverse drug effects (ADEs) in patients with diabetes who were taking Angiotensin converting enzyme inhibitors (ACEI) or Angiotensin II Receptor Blockers (ARBs II) to provide guidance as to how these medications could affect outcomes in acute respiratory illnesses such as SARS-CoV-2 infection.
The study findings were published in the Journal of the American Pharmacists Association. https://www.japha.org/article/S1544-3191(20)30261-2/fulltext
The current demographic information reports that 10%-19% of patients hospitalized with COVID-19 in China were diabetic. ACEIs and ARBs are considered first line agents in patients with diabetes because of their nephroprotective effects. Administration of these drugs leads to up-regulation of angiotensin-converting enzyme 2 (ACE2), which is paving way for the viral entry of SARS-CoV-2 virus. Data are lacking as to what pulmonary effects ACEIs or ARBs may have in patients with diabetes, which could be relevant in the management of patients infected with SARS-CoV-2 virus.
In order to conduct the study, the researchers collected data using '1DATA' which is a unique data platform. 1DATA used an intelligent medicine recommender system called 1DrugAssist which was developed using several national and international databases to evaluate all ADEs reported to the Food and Drug Administration for patients with diabetes taking ACEIs or ARBs.
The main key findings of this study were:
Data mining elucidated the proportion of a cluster of pulmonary ADEs associated with specific medications in these classes, which may aid health care professionals in understanding how these medications could worsen or predispose patients with diabetes to infections affecting the respiratory system, specifically COVID-19.
Form the data mining process, captopril was fou
nd to have a statistically significantly higher incidence of pulmonary ADEs compared with other ACEIs (P ¼ 0.005) as well as ARBs (P ¼ 0.012), though other specific drugs also had important pulmonary ADEs associated with their use.
The study team concluded the study saying that, the specific medication's adverse event profile should be considered, particularly captopril, on how it may alter the pulmonary functions in infections like COVID 19.
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