The onset of a sprue-like enteropathy in association with olmesartan therapy has been recently reported.
Dr Cammarota and colleagues performed a systematic review of the literature, and described 3 additional cases of olmesartan-associated enteropathy.
Electronic and manual bibliographic searches were performed to identify original reports in which subjects who were undertaking olmesartan developed a sprue-like enteropathy.
Because of the scarcity of studies with adequate sample size, case series with less than 10 patients and case reports were also considered.
Data extraction was performed independently by 2 reviewers.
|Antibody testing for celiac disease was always negative|
|Alimentary Pharmacology & Therapeutics|
The team reported that a total of 11 publications met pre-defined inclusion criteria, for an overall number of 54 patients.
The researchers noted that almost all patients presented with diarrhea and weight loss.
Normocytic normochromic anemia and hypoalbuminemia were the commonest laboratory defects at presentation.
The team observed that antibody testing for celiac disease was always negative.
The researchers found variable degrees of duodenal villous atrophy present in 98% of patients, while increased intra-epithelial lymphocytes were documented in only 65% of cases.
After discontinuation of olmesartan, all reported patients achieved resolution of signs and symptoms.
Dr Cammarota's team concludes, "Although the available evidence is limited, the olmesartan-associated sprue-like enteropathy may be considered as a distinct clinical entity, and should be included in the differential diagnosis when serological testing for celiac disease is negative."