Olmesartan medoxomil
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First report of a sprue-like enteropathy: 22 case reports A study identified 13 women and 9 men, aged 47–81 years, who developed a sprue-like enteropathy during treatment with olmesartan medoxomil [indication not clearly stated]. The patients had been receiving olmesartan medoxomil 10–40 mg/day for 0.5–7 years before their symptoms began [route not stated; time to reaction onset not stated for 3 patients]. All had diarrhoea and weight loss; other symptoms included nausea, vomiting, abdominal pain, bloating and fatigue. All but one patient had severe enteropathy; 14 patients had been admitted with severe dehydration. Investigations revealed negative IgA tissue transglutimase antibodies, and histology revealed vilious atrophy in all patients. A gluten-free diet had been trialled in 20 patients, to no apparent clinical benefit. Olmesartan was withdrawn, and all patients had a clinical response, with resolution of diarrhoea; a normal intestinal biopsy result was observed in 17 of the 18 tested patients; the remaining. While formal rechallenge was not undertaken, two patients reported an anecdotal worsening of their symptoms after restarting olmesartan medoxomil, and two experienced improvement during treatment cessation during a hospitalisation, with a worsening after discharge and reintroduction of olmesartan medoxomil. Author comment: "We report a unique case series to support a novel association between severe spruelike enteropathy and olmesartan." Rubio-Tapia A, et al. Severe spruelike enteropathy associated with olmesartan. Mayo Clinic Proceedings 87: 732-738, No. 8, Aug 2012. Available from: URL: 803081129 http://dx.doi.org/10.1016/j.mayocp.2012.06.003 - USA
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Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of spruelike enteropathy associated with olmesartan medoxomil. The WHO ADR database contained 3 reports of malabsorption associated with olmesartan medoxomil.
0114-9954/10/1432-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 15 Dec 2012 No. 1432
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