Losartan May Not Prevent Vestibular Schwannoma Growth or Related Hearing Loss During Observation.

Autor:	Lovin BD, Nader ME; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center., Qing Y; Department of Biostatistics, The University of Texas MD Anderson Cancer Center., Hernandez M; Department of Biostatistics, The University of Texas MD Anderson Cancer Center., Raza S; Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., DeMonte F; Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, Texas., Gidley PW; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center.
Jazyk:	angličtina
Zdroj:	Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology [Otol Neurotol] 2024 Jul 01; Vol. 45 (6), pp. 690-695.
DOI:	10.1097/MAO.0000000000004214
Abstrakt:	Objective: To evaluate the impact of losartan on vestibular schwannoma (VS) growth and related hearing loss during observation. Study Design: Retrospective cohort study. Setting: Tertiary referral center. Patients: Sporadic VS patients undergoing initial observation with at least two magnetic resonance imaging and audiologic examinations. Intervention: Losartan. Main Outcome Measures: Endpoints included VS growth, quantitative audiologic changes, survival free of tumor growth, and survival free of nonserviceable hearing. Patient characteristics and endpoints were compared by losartan use. Results: Seventy-nine patients were included, of which 33% were taking losartan. Tumor growth was observed in 50% of patients in the losartan group and 36% in the non-losartan group (p = 0.329). Survival analysis failed to show a significant difference in the hazard rate of VS growth between groups (hazard ratio, 1.38; 95% confidence interval, 0.70-2.70; p = 0.346). Throughout observation, mean decreases in normalized pure-tone average were 5.5 and 9.3 dB in the losartan and non-losartan groups, respectively (p = 0.908). Mean decreases in normalized word recognition score were 11.0 and 16.6% in the losartan and non-losartan groups, respectively (p = 0.757). Nonserviceable hearing developed in 19% of patients in the losartan group and 28% in the non-losartan group (p = 0.734). Survival analysis did not demonstrate a significant difference in the hazard rate of developing nonserviceable hearing between groups (hazard ratio, 1.71; 95% confidence interval, 0.56-5.21; p = 0.337). Conclusions: Losartan use may not reduce the risk of VS growth or hearing loss during observation. A randomized trial would be ideal to further identify the true effect on growth and hearing. Competing Interests: Conflicts of interest: M.E.N. reports stock ownership in 3M, Amgen, Cardinal Health, Johnson & Johnson, Medtronic, and Pfizer. P.W.G. reports stock ownership in Amgen, Eli Lily, Merck, Medtronic, Novartis, Pfizer, and Roche. There are no conflicts of interest to declare for the remaining authors. (Copyright © 2024, Otology & Neurotology, Inc.)
Databáze:	MEDLINE
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