Can captopril reduce rate of RP failures?

A potentially important Swedish pilot study has shown that men treated with the old cardiovascular drug captopril (Capoten) following radical prostatectomy had a very significant reduction in biochemical recurrence over an average follow-up of 29 months compared to untreated patients.

This was only a small study involving 62 patients, 32 of whom received captopril. However, Ronquist et al. report that the incidence of biochemical failure in the captopril-treated group was only 3/32 (9.4 percent) compared to 10/30 (33.3 percent) in the control group. That is a big difference!

The authors are very clear that, “a larger study may show no evidence of an association,” but there seems to be little doubt that that larger study needs to be carried out, and soon, in a randomized, double-blind, placebo-controlled, multi-center manner. The first question is whether these results can be confirmed. The second, and even more important question, is whether this reduction in risk for biochemical recurrence translates into a reduction in risk for metastatic disease and death.

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