Benjamin D Lovin, Marc-Elie Nader, Yun Qing, Mike Hernandez, Shaan Raza, Franco DeMonte, Paul W Gidley
{"title":"洛沙坦在观察期间可能无法预防前庭许旺瘤的生长或相关听力损失。","authors":"Benjamin D Lovin, Marc-Elie Nader, Yun Qing, Mike Hernandez, Shaan Raza, Franco DeMonte, Paul W Gidley","doi":"10.1097/MAO.0000000000004214","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of losartan on vestibular schwannoma (VS) growth and related hearing loss during observation.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Sporadic VS patients undergoing initial observation with at least two magnetic resonance imaging and audiologic examinations.</p><p><strong>Intervention: </strong>Losartan.</p><p><strong>Main outcome measures: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19732,"journal":{"name":"Otology & Neurotology","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178252/pdf/","citationCount":"0","resultStr":"{\"title\":\"Losartan May Not Prevent Vestibular Schwannoma Growth or Related Hearing Loss During Observation.\",\"authors\":\"Benjamin D Lovin, Marc-Elie Nader, Yun Qing, Mike Hernandez, Shaan Raza, Franco DeMonte, Paul W Gidley\",\"doi\":\"10.1097/MAO.0000000000004214\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate the impact of losartan on vestibular schwannoma (VS) growth and related hearing loss during observation.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>Sporadic VS patients undergoing initial observation with at least two magnetic resonance imaging and audiologic examinations.</p><p><strong>Intervention: </strong>Losartan.</p><p><strong>Main outcome measures: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":19732,\"journal\":{\"name\":\"Otology & Neurotology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178252/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Otology & Neurotology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MAO.0000000000004214\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otology & Neurotology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MAO.0000000000004214","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Losartan May Not Prevent Vestibular Schwannoma Growth or Related Hearing Loss During Observation.
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.
期刊介绍:
Otology & Neurotology publishes original articles relating to both clinical and basic science aspects of otology, neurotology, and cranial base surgery. As the foremost journal in its field, it has become the favored place for publishing the best of new science relating to the human ear and its diseases. The broadly international character of its contributing authors, editorial board, and readership provides the Journal its decidedly global perspective.