| AIMS
Lisinopril is an angiotensin-converting-enzyme inhibitor that is largely administered for off-label uses. This study aims to provide a
comprehensive review of off-label uses of lisinopril to aid physicians to make evidence-based decisions.
METHODS
The following bibliographic databases were searched from inception up to 30 March 2017: PubMed, EMBASE, the Cochrane
Library, Cochrane Central Register of Controlled Trials, Scopus, Ovid and Proquest. This systematic review sought all randomized
trials conducted on adult individuals comparing lisinopril on its off-label uses with alternative drugs or placebos and reported
direct or alternative clinical outcomes. Risk of bias assessment by using the Cochrane Collaboration risk-of-bias tool and quality
evaluation took place.
RESULTS
Included studies demonstrated significant positive effects of lisinopril on proteinuric kidney disease; however, lisinopril caused a
slight reduction of glomerular filtration rate (GFR) especially for patients with GFR < 90 ml min–1. Lisinopril offered better
outcomes in comparison to other standard treatments of diabetic nephropathy. Other studies showed positive effects of lisinopril
for migraine, prevention of diabetes, myocardial fibrosis, mitral valve regurgitation, cardiomyopathy in patients with Duchenne
muscular dystrophy, oligospermia and infertility, and diabetic retinopathy. Conversely, the studies reported that lisinopril was
ineffective for five other off-label uses.
CONCLUSIONS
The identified studies showed that lisinopril was highly effective for proteinuric kidney disease with a minor but inconsiderable
decrease in GFR. Positive effects of lisinopril were demonstrated in seven other off-label uses; however, lisinopril cannot be recommended
as the first choice for these until further clinical trials confirm these positive effects. |