Medical treatment of Marfan syndrome: a time for change

It is accepted practice to prescribe beta-blockers in order to retard aortic dilatation and prevent aortic dissection and rupture in patients with Marfan syndrome. A critical review of the published pharmacological studies shows this practice to be based on limited evidence. The data from small clin...

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Bibliographic Details
Published in:	Heart (British Cardiac Society) Vol. 94; no. 4; p. 414
Main Authors:	Williams, A, Davies, S, Stuart, A G, Wilson, D G, Fraser, A G
Format:	Journal Article
Language:	English
Published:	England 01-04-2008
Subjects:	Adrenergic beta-Antagonists - therapeutic use Angiotensin II Type 1 Receptor Blockers - therapeutic use Angiotensin-Converting Enzyme Inhibitors - therapeutic use Calcium Channel Blockers - therapeutic use Cardiovascular Agents - therapeutic use Humans Losartan - therapeutic use Marfan Syndrome - drug therapy Marfan Syndrome - genetics Marfan Syndrome - physiopathology
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Summary:	It is accepted practice to prescribe beta-blockers in order to retard aortic dilatation and prevent aortic dissection and rupture in patients with Marfan syndrome. A critical review of the published pharmacological studies shows this practice to be based on limited evidence. The data from small clinical and experimental studies with surrogate end points suggest greater potential benefit from alternative drug regimens, and a recent experimental study showed that losartan may interrupt the mechanism of disease as well as deal with its functional consequences. It is now essential to perform large, collaborative, randomised controlled trials with clinical end points of new treatments in Marfan syndrome.
ISSN:	1468-201X
DOI:	10.1136/hrt.2006.109454