Olmesartan-associated enteropathy: results of a national survey

Abstract

SUMMARY BackgroundRecently, a new enteropathy has been described: olmesartan-associated enteropathy. However, the association has been questioned: a phase 3 trial and a cohort study found no association between gastrointestinal events and olmesartan.

Olmesartan-Associated Enteropathy: A Review of Clinical and Histologic Findings

“…Based on cases reported to date, [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] OAE affects both men and women equally, and it most frequently affects patients in the seventh to eighth decades of life (mean age, 68 years; range, 46-91 years). Most patients with OAE present with chronic nonbloody diarrhea and weight loss.…”

“…Detection of anti-enterocyte antibodies 3 and antinuclear antibodies 11 has been reported in a few cases. Either HLA-DQ2 or HLA-DQ8 was identified in 45 of 65 individuals (69%) with OAE, most of whom showed HLA-DQ2.…”

“…16,19 Reported abnormal endoscopic features of the small bowel include mucosal nodularity, villous atrophy, and ulceration. 5,10,11,14,17,18,20 …”

“…Of the cases we identified in the literature with duodenal biopsies, 92 of 100 individuals (92%) had total or partial villous blunting (Figures 1 and 2). 3,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] A total of 5 biopsies (5%) had normal duodenal villous architecture, 11,14 2 of which had increased intraepithelial lymphocytes.…”

“…1 There are approximately 100 cases currently reported in the English-language literature that support olmesartan-associated enteropathy (OAE) as a distinct clinical entity. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] The aim of this article is to provide a review of clinicopathologic findings of OAE with a focus on microscopic features of gastrointestinal tract biopsies described in the literature as well as to provide a brief discussion of other entities to consider in the differential diagnosis of OAE. Original case reports and series published in the Englishlanguage literature of patients who developed enteropathy while on olmesartan therapy were identified through electronic searches in PubMed as well as manual bibliographic searches.…”