Study warns against use of quinapril to treat digital ulcers in cutaneous sclerosis patients

Bangor, Wales - British researchers report that quinapril, a long-acting angiotensin-converting enzyme (ACE) inhibitor, does not appear to prevent upper-limb digital ulcers or other vascular manifestations in patients with limited cutaneous systemic sclerosis (lcSSc), reports Reuters Health.

Researchers from the University of Wales, Bangor studied 210 patients with lcSSc or Raynaud’s phenomenon with SSc-specific antinuclear antibodies. They were randomized in a double-blind fashion to daily quinapril or placebo, plus their usual therapy. Two- to three-year follow-up showed that quinapril did not affect the occurrence of digital ulcers or the frequency or severity of Raynaud’s episodes.

About 20 percent of the assigned patients were unable to tolerate quinapril; dry or persistent coughs appear to be the most common side effect. No serious unexpected adverse reactions are reported in the study, which appeared in the November issue of Arthritis and Rheumatism.

The study concludes that based on these results, the routine use of ACE inhibition in treating upper-limb digital ulcers or other vascular manifestations in patients with systemic sclerosis is not advisable.