{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T06:22:30Z","timestamp":1782800550075,"version":"3.54.5"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T00:00:00Z","timestamp":1644969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001922","name":"Efficacy and Mechanism Evaluation Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001922","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This trial aimed to determine the efficacy of leucine and\/or perindopril in improving physical function in older people with sarcopenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Placebo\u2010controlled, parallel group, double\u2010blind, randomized two\u2010by\u2010two factorial trial. We recruited adults aged\u00a0\u2265\u00a070\u00a0years with sarcopenia, defined as low gait speed (&lt;0.8\u00a0m\/s on 4\u00a0m walk) and\/or low handgrip strength (women\u00a0&lt;\u00a020\u00a0kg, men\u00a0&lt;\u00a030\u00a0kg) plus low muscle mass (using sex and body mass index category\u2010specific thresholds derived from normative UK BioBank data) from 14 UK centres. Eligible participants were randomized to perindopril 4\u00a0mg or placebo, and to oral leucine powder 2.5\u00a0g or placebo thrice daily. The primary outcome was the between\u2010group difference in the short physical performance battery (SPPB) score over 12\u2010month follow\u2010up by repeated\u2010measures mixed models. Results were combined with existing systematic reviews using random\u2010effects meta\u2010analysis to derive summary estimates of treatment efficacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We screened 320 people and randomized 145 participants compared with an original target of 440 participants. For perindopril [<jats:italic>n<\/jats:italic>\u00a0=\u00a073, mean age 79 (SD 6), female sex 39 (53%), mean SPPB 7.1 (SD 2.3)] versus no perindopril [<jats:italic>n<\/jats:italic>\u00a0=\u00a072, mean age 79 (SD 6), female sex 39 (54%), mean SPPB 6.9 (SD 2.4)], median adherence to perindopril was lower (76% vs. 96%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Perindopril did not improve the primary outcome [adjusted treatment effect \u22120.1 points (95%CI \u22121.2 to 1.0), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.89]. No significant treatment benefit was seen for any secondary outcome including muscle mass [adjusted treatment effect \u22120.4\u00a0kg (95%CI \u22121.1 to 0.3), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.27]. More adverse events occurred in the perindopril group (218 vs. 165), but falls rates were similar. For leucine [<jats:italic>n<\/jats:italic>\u00a0=\u00a072, mean age 78 (SD 6), female sex 38 (53%), mean SPPB 7.0 (SD 2.1)] versus no leucine [<jats:italic>n<\/jats:italic>\u00a0=\u00a072, mean age 79 (SD 6), female sex 40 (55%), mean SPPB 7.0 (SD 2.5)], median adherence was the same in both groups (76% vs. 76%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.99). Leucine did not improve the primary outcome [adjusted treatment effect 0.1 point (95%CI \u22121.0 to 1.1), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.90]. No significant treatment benefit was seen for any secondary outcome including muscle mass [adjusted treatment effect \u22120.3\u00a0kg (95%CI \u22121.0 to 0.4), <jats:italic>P<\/jats:italic>\u00a0=\u00a00.47]. Meta\u2010analysis of angiotensin converting enzyme inhibitor\/angiotensin receptor blocker trials showed no clinically important treatment effect for the SPPB [between\u2010group difference \u22120.1 points (95%CI \u22120.4 to 0.2)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neither perindopril nor leucine improved physical performance or muscle mass in this trial; meta\u2010analysis did not find evidence of efficacy of either ACE inhibitors or leucine as treatments to improve physical performance.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.12934","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T03:35:02Z","timestamp":1645068902000},"page":"858-871","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Effect of perindopril or leucine on physical performance in older people with sarcopenia: the LACE randomized controlled 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