THERAPY DOSSIER · th-138de525b60d

Enalapril (angiotensin converting enzyme inhibitor) or eplerenone (mineralocorticoid receptor antagonist)

Drug · Angiotensin-converting enzyme (ACE) inhibitor (INHIBITOR)

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Evidence & regulatory context

Mechanism: Angiotensin-converting enzyme (ACE) inhibitor (INHIBITOR)
Target: Angiotensin-converting enzyme (ACE, CHEMBL1808)
Injury models: Chemical/toxin · Radiation
Reported indication: Not recorded
First approval: 1985
Development stage: Not recorded
ChEMBL record: CHEMBL578 ↗
ChEMBL max phase: 4 / 4 (development scale, not regulatory approval)
Synonyms: Enalapril; Vaseretic; Lexxel; enalapril maleate
Note: Not recorded

Clinical trials 10

0 linked trials carry an injury-indication flag. These flags support record-level exploration and sit alongside the stringent aggregate counts described in Methods.

NCT04023227 ↗PHASE4completed

Trial title not recorded

Chagas Disease · Heart Failure

Enrolment: 922 · Results not recorded

NCT03472508 ↗PHASE4unknown

Trial title not recorded

Hypertension

Enrolment: 3600 · Results not recorded

NCT00433836 ↗PHASE3completed

Trial title not recorded

Hypertension

Enrolment: 300 · Results not recorded

NCT03917459 ↗PHASE3completed

Trial title not recorded

Heart Failure · Heart Failure, Systolic · Erectile Dysfunction

Enrolment: 27 · Results not recorded

NCT02432885 ↗PHASE3completed

Trial title not recorded

Myocardial Fibrosis · Muscular Dystrophies

Enrolment: 76 · Results not recorded

NCT00568178 ↗PHASE3completed

Trial title not recorded

Proteinuria

Enrolment: 306 · Results not recorded

NCT02252692 ↗PHASE1unknown

Trial title not recorded

Heart Failure

Enrolment: 24 · Results not recorded

NCT00484068 ↗NAcompleted

Trial title not recorded

Microalbuminuria · Diabetic Nephropathy

Enrolment: 28 · Results not recorded

NCT03259399 ↗NAunknown

Trial title not recorded

Enalapril Adverse Reaction · Stroke

Enrolment: 2200 · Results not recorded

NCT01096121 ↗NAterminated

Trial title not recorded

Sickle Cell Disease

Enrolment: 5 · Results not recorded

Preclinical evidence 2

2 studies reported at therapy level; 2 evidence entries itemised.

PMID 29016737 ↗2018Mixed findings

Diverging effects of enalapril or eplerenone in primary prevention against doxorubicin-induced cardiotoxicity.

MouseChemical/toxinC57BL/6 (MeSH indexed), including cardiomyocyte-specific mineralocorticoid receptor knockout transgenic miceMaleDoxorubicin 15 mg/kg single injection (acute) or 4 mg/kg pe…Drugs provided with the first dose of doxorubicin (primary prevention)

Model: Doxorubicin-induced cardiotoxicity: acute model with a single injection of doxorubicin 15 mg/kg; chronic model with five injections of doxorubicin 4 mg/kg per week

Neither mineralocorticoid receptor antagonism nor angiotensin converting enzyme inhibition protected against acute doxorubicin cardiotoxicity. In the chronic model eplerenone was not protective and raised plasma aldosterone and cardiac connective tissue growth factor, whereas enalapril preserved le…

Extraction: extract · Supplied extraction confidence: 0.6. Machine-extracted fields require source verification.

PMID 23480564 ↗2013Reported benefit

Enalapril mitigates focal alveolar lesions, a histological marker of late pulmonary injury by radiation to the lung.

RatRadiationWAG/RijCmcrFemalen = 13 Gy alone n = 8; enalapril 60 mg/L n = 40 and 30 mg/L n =…Oral, in drinking water30 or 60 mg/L in drinking water, reported to deliver 12.5 t…Started at 1, 5, 10, 15 or 20 weeks after irradiation

Model: Single dose of 5 to 13 Gy X-rays to the whole thorax (320 kVp orthovoltage, half-value layer 1.4 mm Cu, dose rate 1.43 Gy/min, two equally weighted lateral beams); late lung injury assessed 20 to 71 weeks after irradiation

Enalapril reduced radiation-induced pulmonary cholesterol clefts from 18.7 plus or minus 4.2 per lung section to 6.8 plus or minus 2.4 (p = 0.029), 5.2 plus or minus 1.9 (p = 0.0051) and 6.7 plus or minus 1.9 (p = 0.029) when started at 1, 5 and 15 weeks after 13 Gy. Pooled analysis confirmed mitig…

Extraction: extract · Supplied extraction confidence: 0.95. Machine-extracted fields require source verification.

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