Lotensin (benazepril) is an angiotensin-converting enzyme (ACE) inhibitor developed by Novartis. The therapy’s marketing rights were sold to Validus Pharmaceuticals in 2012. A generic form of the treatment also is available from several companies. Lotensin is approved by the U.S. Food and Drug Administration (FDA) to treat high blood pressure (hypertension). Lotensin also may be used to reduce a strain on the kidneys in patients with Alport syndrome.

How Lotensin works

Alport syndrome is a serious inherited disease that causes progressive kidney problems. In the early stages of the disease, most patients have blood or protein in their urine. As the disease progresses, patients develop scarring in the kidneys, which can lead to kidney failure, also known as end-stage kidney disease.

ACE inhibitors like Lotensin work by inhibiting ACE, which normally converts a protein called angiotensin 1 into a different form, angiotensin 2. Angiotensin 2 increases blood pressure by constricting blood vessels and increasing blood volume by causing the kidneys to retain water and sodium and excrete potassium.

By blocking ACE, Lotensin decreases blood pressure and increases the excretion of sodium by the kidneys while reducing the amount of potassium excretion. These factors are thought to reduce the strain on kidneys in Alport syndrome patients, which may increase lifespan and delay the onset of kidney failure.

Lotensin in clinical trials

A Phase 2 clinical trial (NCT00309257), the results of which were published in the scientific journal Nephronassessed the effects of Lotensin in combination with other treatments in nine Alport syndrome patients. Patients stopped taking their usual medications for a month-long washout period, followed by four-month add-on treatment with Lotensin, valsartan (an angiotensin 2 receptor blocker), diltiazem (a calcium channel blocker), and fluvastatin (a statin).

This was followed by a one-month washout period. At month four, protein levels in patients’ urine were assessed. After the final washout period, one patient declined to continue the trial, one patient reached kidney failure, and seven patients had normal blood levels of creatinine, a measure of how well the kidneys are filtering blood.

Seven patients continued treatment for 10 years from the study’s start, with kidney function being assessed monthly until either trial withdrawal or the onset of kidney failure. At the final visit, three patients had extremely low levels of protein in the urine, and one had normal levels.

Researchers concluded that the combination therapy may be promising in halting disease progression in patients who are not in kidney failure before the start of treatment.

Other information

Lotensin may cause side effects, including sweats, chills, dizziness, and confusion.

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