Abstract
Background
This study was designed to comparatively assess the effects of add-on pentoxifylline
to losartan versus increasing the dose of losartan on serum N-terminal pro-brain natriuretic
peptide (NT-proBNP), serum highly sensitive C-reactive protein (hsCRP) and the urinary
albumin excretion (UAE) rate in patients with type 2 diabetes and nephropathy.
Methods
In an open-label, single-center, parallel-group, randomized clinical trial (NCT03006952),
30 patients received b.i.d. dose of pentoxifylline 400 mg plus daily dose of losartan 50 mg (pentoxifylline arm) and 29 patients received b.i.d. dose of losartan 50 mg (losartan arm) during a 12-week follow-up period.
Results
Serum NT-proBNP, serum hsCRP and UAE levels all significantly decreased from baseline
in both trial arms. The pentoxifylline and losartan trial arms were equally effective
in reducing serum NT-proBNP levels during the course of trial (multivariable adjusted
model P value = 0.864, effect size = 0.2%). There was a greater decrease in UAE and serum
hsCRP levels in the pentoxifylline arm (P = 0.034, effect size = 7.8%; P = 0.009, effect size = 11.7%, respectively). Conversely, patients in the losartan
arm achieved better systolic and diastolic blood pressure control (P < 0.001, effect size = 25.4%; P = 0.010, effect size = 11.3%, respectively).
Conclusions
Circulating NT-proBNP levels equally and significantly reduced from baseline in the
pentoxifylline and losartan treatment arms, in parallel with comparatively superior
decreases of UAE and serum hsCRP in the pentoxifylline arm, and larger decreases of
systolic and diastolic blood pressures in the losartan arm.
Key Indexing Terms
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Article info
Publication history
Accepted:
December 25,
2017
Received:
July 13,
2017
Footnotes
☆The authors have no conflicts of interest to disclose.
☆☆This study was funded by Tehran University of Medical Sciences.
Identification
Copyright
© 2018 Southern Society for Clinical Investigation. Published by All rights reserved.
