{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:45:57Z","timestamp":1788997557863,"version":"build-2803163510"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2018,12]]},"abstract":"\n Background<\/jats:title>\n The comparative effectiveness of treatment with angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or their combination in people with albuminuria and cardiovascular risk factors is unclear.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In a multicenter, randomized, open label, blinded end point trial, we evaluated the effectiveness on cardiovascular events of ACE or ARB monotherapy or combination therapy, targeting BP<130\/80 in patients with moderate or severe albuminuria and diabetes or other cardiovascular risk factors. End points included a primary composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, and hospitalization for cardiovascular causes and a revised end point of all-cause mortality. Additional end points included ESRD, doubling of serum creatinine, albuminuria, eGFR, BP, and adverse events.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Because of slow enrollment, the trial was modified and stopped 41% short of targeted enrollment of 2100 participants, corresponding to 35% power to detect a 25% reduced risk in the primary outcome. Our analysis included 1243 adults, with median follow-up of 2.7 years. Efficacy outcomes were similar between groups (ACE inhibitor versus ARB, ACE inhibitor versus combination, ARB versus combination) as were rates of serious adverse events. The rate of permanent discontinuation for ARB monotherapy (6.3%) was significantly lower than for ACE inhibitor monotherapy (15.7%) or combined therapy (18.3%).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Patients may tolerate ARB monotherapy better than ACE inhibitor monotherapy. However, data from this trial and similar trials, although as yet inconclusive, show no trend suggesting differences in mortality and renal outcomes with ACE inhibitors or ARBs as dual or monotherapy in patients with albuminuria and diabetes or other cardiovascular risk factors.<\/jats:p>\n <\/jats:sec>","DOI":"10.1681\/asn.2018040443","type":"journal-article","created":{"date-parts":[[2018,11,12]],"date-time":"2018-11-12T11:26:17Z","timestamp":1542021977000},"page":"2890-2899","source":"Crossref","is-referenced-by-count":36,"title":["The Long-Term Impact of Renin-Angiotensin System (RAS) Inhibition on Cardiorenal Outcomes (LIRICO): A Randomized, Controlled Trial"],"prefix":"10.1681","volume":"29","author":[{"given":"Valeria","family":"Saglimbene","sequence":"first","affiliation":[{"name":"Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden;"},{"name":"Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suetonia C.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marinella","family":"Ruospo","sequence":"additional","affiliation":[{"name":"Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Natale","sequence":"additional","affiliation":[{"name":"Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden;"},{"name":"Emergency and Organ Transplantation and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ausilia","family":"Maione","sequence":"additional","affiliation":[{"name":"Freelance Consultant (formerly Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S Maria Imbaro, Chieti, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Nicolucci","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariacristina","family":"Vecchio","sequence":"additional","affiliation":[{"name":"Department of Hydration and Health, Danone Research, Palaiseau, France;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni","family":"Tognoni","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Craig","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, Faculty of Medicine and Health, Sydney, Australia;"},{"name":"College of Medicine and Public Health, Flinders University, Health Sciences Building, Adelaide 5001, South Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Pellegrini","sequence":"additional","affiliation":[{"name":"Worldwide Medical, Biogen, Cambridge, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Lucisano","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rgen","family":"Hegbrant","sequence":"additional","affiliation":[{"name":"Medical Scientific Office, Diaverum Renal Services Group, Lund, Sweden;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Ariano","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Dialysis, Azienda Ospedaliera Instituti Ospedalieri di Cremona, Cremona, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Lamacchia","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Azienda Ospedaliera Universitaria Foggia, Foggia, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sasso","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ospedale Civile S. Pellegrino, Trani, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanna","family":"Morano","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Azienda Policlinico Umberto I\u2014Universit\u00e0 La Sapienza, Rome, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Filardi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Azienda Policlinico Umberto I\u2014Universit\u00e0 La Sapienza, Rome, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"De Cosmo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Scientific Institute Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Pugliese","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine, \u201cLa Sapienza\u201d 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