The Ghent Marfan Trial--a randomized, double-blind placebo controlled trial with losartan in Marfan patients treated with β-blockers

Int J Cardiol. 2012 Jun 14;157(3):354-8. doi: 10.1016/j.ijcard.2010.12.070. Epub 2011 Jan 15.


Background: Aortic root dilation, dissection and rupture are major clinical problems in Marfan syndrome (MFS). Although β-blockers remain the standard of preventive treatment, preliminary results from animal studies and a selected group of severely affected MFS children show significant benefit from treatment with losartan, an angiotensin II receptor blocker with TGF-β inhibiting potential. Large-scale human trials are now needed to confirm these results. This trial aims to evaluate the combined effect of both drugs.

Methods: We are conducting a prospective randomized placebo controlled double blind phase III study aiming to include 174 MFS patients (age ≥ 10 years and z-score ≥ 2). Patients already taking β-blockers are randomized for weight-adjusted treatment with losartan versus placebo. The primary endpoint is decrease in aortic root growth rate. Secondary endpoints are aortic dissection/surgery, progression of aortic/mitral regurgitation, arterial stiffness, left ventricular systolic/diastolic function, quality of life and genetic modifiers. Echocardiography, vascular echo-Doppler and quality of life assessment will be performed at baseline and at 6-monthly follow-ups for 3 years. MRI evaluation will be performed at baseline and at the end of the trial.

Conclusion: This trial will study new therapeutic strategies for the prevention of serious cardiovascular complications in MFS. The uniqueness in our trial is that the additive effect of losartan and β-blocker will be evaluated in a large spectrum of disease severity. A combination of ultrasound and MRI will allow detailed evaluation of anatomic and functional properties of the aorta and left ventricle.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Aged
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Belgium / epidemiology
  • Child
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Humans
  • Losartan / therapeutic use*
  • Male
  • Marfan Syndrome / drug therapy*
  • Marfan Syndrome / epidemiology*
  • Middle Aged
  • Placebos
  • Prospective Studies
  • Young Adult


  • Adrenergic beta-Antagonists
  • Angiotensin II Type 1 Receptor Blockers
  • Placebos
  • Losartan