ReviewGastroenterology report2019
Angiotensin II receptor blockers and gastrointestinal adverse events of resembling sprue-like enteropathy: a systematic review.
Review in Gastroenterology report, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 58 citations in OpenAlex.
- Article
- Article
- Nephroprotective Effect ofInternational journal of molecular sciences · 2025Review
- Atypical Rapid Onset of Olmesartan-Induced Enteropathy with Recurrence After Rechallenging.Diseases (Basel, Switzerland) · 2025Article
- Risk factor of severe diarrhea and enterocolitis induced by CAPOX: a retrospective multicenter study.ESMO gastrointestinal oncology · 2024Article
- Pathognomonic Features of Olmesartan-Induced Collagenous Sprue Resulting in Severe Small Bowel Malabsorption.Cureus · 2024Article
- Chronic diarrhoea, weight loss and a positive anti-tissue transglutaminase antibody: A case report of olmesartan-induced enteropathy.BMJ case reports · 2024Article
- Enteropathy and intestinal malabsorption in patients treated with antihypertensive drugs.Saudi medical journal · 2024Article
- A Rare Case of Olmesartan-Associated Enteropathy Successfully Managed With Steroid Taper.Cureus · 2023Article
- Olmesartan-Induced Ischemic Enteritis Complicated With Bowel Perforation: A Case Report and Literature Review.Cureus · 2023Article
- Collagenous sprue: a rare cause of watery diarrhea and villous atrophy - case report.Gastroenterology and hepatology from bed to bench · 2023Article
- Olmesartan-associated sprue-like enteropathy.BMJ case reports · 2022Article
- The histological spectrum of ARB-induced gastritis.Histopathology · 2022Article
- Angiotensin II receptor blockers (ARBs) and manufacturing contamination: A retrospective National Register Study into suspected associated adverse drug reactions.British journal of clinical pharmacology · 2022Article
- A Case of Sprue-like Enteropathy Associated With Valsartan and Irbesartan.Journal of neurogastroenterology and motility · 2022Article
- Olmesartan-associated Enteropathy with Acute Kidney Injury.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2022Article
- Shuttling of cellular proteins between the plasma membrane and nucleus (Review).Molecular medicine reports · 2022Review
- An elderly woman with severe enteritis mimicking infectious enteritis.Intestinal research · 2021Article
- Coeliac disease enteropathy and symptoms may be aggravated by angiotensin receptor blockers in patients on a gluten-free diet.United European gastroenterology journal · 2021Article
- Cutaneous ulcers in association with sprue-like enteropathy secondary to Losartan.Clinical case reports · 2021Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOlmesartan, an angiotensin II receptor blocker (ARB), is associated with gastrointestinal symptoms resembling sprue-like enteropathy. Some have proposed that enteropathy may be a class effect rather than olmesartan-specific. We performed a systematic review to identify literature of sprue-like enteropathy for all ARBs.
methodsCase reports, case series and comparative studies of ARBs were searched on PubMed and Embase databases through 21 November 2018 and then assessed.
resultsA total of 82 case reports and case series as well as 5 comparative studies, including 248 cases, were selected and analysed. The ARBs listed in the case reports were olmesartan (233 users; 94.0%), telmisartan (5 users; 2.0%), irbesartan (4 users; 1.6%), valsartan (3 users; 1.2%), losartan (2 users; 0.8%) and eprosartan (1 user; 0.4%). The periods between ARB initiation and onset of symptoms ranged from 2 weeks to 13 years. Histologic results were reported in 218 cases, in which 201 cases (92.2%) were villous atrophy and 131 cases (60.1%) were intraepithelial lymphocytosis. Human leucocyte antigen (HLA) testing was performed in 147 patients, among whom 105 (71.4%) had HLA-DQ2 or HLA-DQ8 haplotypes. Celiac-associated antibodies were tested in 169 patients, among whom 167 (98.8%) showed negative results. Gluten exclusion from the diet failed to relieve symptoms of enteropathy in 127 (97.7%) of 130 patients with information. Complete remission of symptoms after discontinuation of ARB was reported in 233 (97.4%) of the 239 patients with information. Seven cases (2.8%) reported recurrence of symptoms after restarting olmesartan; rechallenge was not reported for the non-olmesartan ARBs. The retrospective studies conducted worldwide had inconsistent study designs (e.g. differences in periods of study and case definition) and findings.
conclusionsAlthough enteropathy is rare, clinicians should remain vigilant of this potential adverse event even years after medication initiation.
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