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<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-toc" /><meta name="ncbi_acc" content="NBK583341" /><meta name="ncbi_domain" content="ukeme0908" /><meta name="ncbi_report" content="record" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK583341/" /><meta name="ncbi_pagename" content="Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT - NCBI Bookshelf" /><meta name="ncbi_bookparttype" content="toc" /><meta name="ncbi_app" content="bookshelf" />
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<title>Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT - NCBI Bookshelf</title>
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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE,NOIMAGEINDEX" /><meta name="author" content="Miles D Witham, Simon Adamson, Alison Avenell, Margaret M Band, Tufail Bashir, Peter T Donnan, Jacob George, Adrian Hapca, Cheryl Hume, Paul Kemp, Emma McKenzie, Kristina Pilvinyte, Christos Rossios, Karen Smith, Allan D Struthers, Deepa Sumukadas" /><meta name="citation_title" content="Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT" /><meta name="citation_publisher" content="National Institute for Health and Care Research" /><meta name="citation_date" content="2022/08" /><meta name="citation_author" content="Miles D Witham" /><meta name="citation_author" content="Simon Adamson" /><meta name="citation_author" content="Alison Avenell" /><meta name="citation_author" content="Margaret M Band" /><meta name="citation_author" content="Tufail Bashir" /><meta name="citation_author" content="Peter T Donnan" /><meta 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TRIAL" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute for Health and Care Research" /><meta name="DC.Contributor" content="Miles D Witham" /><meta name="DC.Contributor" content="Simon Adamson" /><meta name="DC.Contributor" content="Alison Avenell" /><meta name="DC.Contributor" content="Margaret M Band" /><meta name="DC.Contributor" content="Tufail Bashir" /><meta name="DC.Contributor" content="Peter T Donnan" /><meta name="DC.Contributor" content="Jacob George" /><meta name="DC.Contributor" content="Adrian Hapca" /><meta name="DC.Contributor" content="Cheryl Hume" /><meta name="DC.Contributor" content="Paul Kemp" /><meta name="DC.Contributor" content="Emma McKenzie" /><meta name="DC.Contributor" content="Kristina Pilvinyte" /><meta name="DC.Contributor" content="Christos Rossios" /><meta name="DC.Contributor" content="Karen Smith" /><meta name="DC.Contributor" content="Allan D Struthers" /><meta name="DC.Contributor" content="Deepa Sumukadas" /><meta name="DC.Date" content="2022/08" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK583341/" /><meta name="description" content="This trial did not find that either perindopril once daily or leucine thrice daily improved physical performance at 12 months." /><meta name="og:title" content="Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT" /><meta name="og:type" content="book" /><meta name="og:description" content="This trial did not find that either perindopril once daily or leucine thrice daily improved physical performance at 12 months." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK583341/" /><meta name="og:site_name" content="NCBI 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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/Book"><div class="meta-content fm-sec"><div class="iconblock whole_rhythm clearfix no_top_margin"><a href="http://www.journalslibrary.nihr.ac.uk/eme" title="National Institute for Health and Care Research" class="img_link icnblk_img" ref="pagearea=logo&targetsite=external&targetcat=link&targettype=publisher"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-ukeme0908-lrg.png" alt="Cover of Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT" /></a><div class="icnblk_cntnt"><h1 id="_NBK583341_"><span itemprop="name">Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the <a href="/books/n/ukeme0908/g1/#g1-def22">LACE</a> factorial RCT</span></h1><p><i>Efficacy and Mechanism Evaluation, No. 9.8</i></p><p class="contrib-group"><span itemprop="author">Miles D Witham</span>, <span itemprop="author">Simon Adamson</span>, <span itemprop="author">Alison Avenell</span>, <span itemprop="author">Margaret M Band</span>, <span itemprop="author">Tufail Bashir</span>, <span itemprop="author">Peter T Donnan</span>, <span itemprop="author">Jacob George</span>, <span itemprop="author">Adrian Hapca</span>, <span itemprop="author">Cheryl Hume</span>, <span itemprop="author">Paul Kemp</span>, <span itemprop="author">Emma McKenzie</span>, <span itemprop="author">Kristina Pilvinyte</span>, <span itemprop="author">Christos Rossios</span>, <span itemprop="author">Karen Smith</span>, <span itemprop="author">Allan D Struthers</span>, and <span itemprop="author">Deepa Sumukadas</span>.</p><a data-jig="ncbitoggler" href="#__NBK583341_ai__" style="border:0;text-decoration:none">Author Information and Affiliations</a><div style="display:none" class="ui-widget" id="__NBK583341_ai__"><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Miles D Witham</span>,<sup>1,2</sup><sup>,*</sup> <span itemprop="author">Simon Adamson</span>,<sup>3</sup> <span itemprop="author">Alison Avenell</span>,<sup>4</sup> <span itemprop="author">Margaret M Band</span>,<sup>3</sup> <span itemprop="author">Tufail Bashir</span>,<sup>5</sup> <span itemprop="author">Peter T Donnan</span>,<sup>3</sup> <span itemprop="author">Jacob George</span>,<sup>2</sup> <span itemprop="author">Adrian Hapca</span>,<sup>3</sup> <span itemprop="author">Cheryl Hume</span>,<sup>3</sup> <span itemprop="author">Paul Kemp</span>,<sup>5</sup> <span itemprop="author">Emma McKenzie</span>,<sup>3</sup> <span itemprop="author">Kristina Pilvinyte</span>,<sup>3</sup> <span itemprop="author">Christos Rossios</span>,<sup>5</sup> <span itemprop="author">Karen Smith</span>,<sup>3</sup> <span itemprop="author">Allan D Struthers</span>,<sup>2</sup> and <span itemprop="author">Deepa Sumukadas</span><sup>6</sup>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> AGE Research Group, NIHR Newcastle Biomedical Research Centre, Newcastle University and Newcastle upon Tyne Hospitals Trust, Newcastle upon Tyne, UK</div><div class="affiliation"><sup>2</sup> Molecular and Clinical Medicine, University of Dundee, Dundee, UK</div><div class="affiliation"><sup>3</sup> Tayside Clinical Trials Unit, University of Dundee, Dundee, UK</div><div class="affiliation"><sup>4</sup> Health Services Research Unit, University of Aberdeen, Aberdeen, UK</div><div class="affiliation"><sup>5</sup> Cardiovascular and Respiratory Interface Section, National Heart and Lung Institute, Imperial College London, London, UK</div><div class="affiliation"><sup>6</sup> Department of Medicine for the Elderly, NHS Tayside, Dundee, UK</div><div class="affiliation"><sup>*</sup> Corresponding author<span class="before-email-separator">; </span><span class="email-label">Email: </span><a href="mailto:dev@null" data-email="ku.ca.eltsacwen@mahtiW.seliM" class="oemail">ku.ca.eltsacwen@mahtiW.seliM</a></div></div><div class="half_rhythm">Southampton (UK): <a href="http://www.journalslibrary.nihr.ac.uk/eme" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=publisher"><span itemprop="publisher">National Institute for Health and Care Research</span></a>; <span itemprop="datePublished">2022 Aug</span>.</div><div class="half_rhythm"><ul class="inline_list"><li><span class="label"><a data-jig="ncbidialog" href="#_ncbi_dlg_cpyrght_NBK583341" data-jigconfig="modal:true">Copyright and
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Permissions</a></span></li></ul></div><div id="_ncbi_dlg_cpyrght_NBK583341" style="display:none" title="Copyright and Permissions"><div><div>Copyright © 2022 Witham et al. This work was produced by Witham et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaption in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/. For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited.</div><div class="half_rhythm"></div></div></div><div class="bk_noprnt"><form method="get" action="/books/n/ukeme0908/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div><div class="body-content whole_rhythm" itemprop="text"><div itemprop="description"><h2>Headline</h2><p>This trial did not find that either perindopril once daily or leucine thrice daily improved physical performance at 12 months.</p></div><div itemprop="description"><h2>Abstract</h2><div id="abs1-1"><h4 class="inline">Background:</h4><p>Angiotensin-converting enzyme inhibitors and leucine are promising potential treatments for sarcopenia. Neither has yet been tested in adequately powered randomised trials in patients with sarcopenia.</p></div><div id="abs1-2"><h4 class="inline">Objectives:</h4><p>To determine the efficacy of leucine and perindopril in improving physical function in older people with sarcopenia, to evaluate the effect of leucine and perindopril on muscle mass and to evaluate the predictive biomarkers of sarcopenia.</p></div><div id="abs1-3"><h4 class="inline">Design:</h4><p>A placebo-controlled, parallel group, double-blind, randomised 2 × 2 factorial trial.</p></div><div id="abs1-4"><h4 class="inline">Setting:</h4><p>Primary care and geriatric medicine secondary care departments in 14 UK centres.</p></div><div id="abs1-5"><h4 class="inline">Participants:</h4><p>Adults aged ≥ 70 years with low muscle strength and mass, without contraindications to angiotensin-converting enzyme inhibitors and without known diagnosis-specific skeletal myopathy.</p></div><div id="abs1-6"><h4 class="inline">Interventions:</h4><p>Eligible participants were randomised 1 : 1 to receive 4 mg of oral perindopril or a matching placebo and, separately, were randomised 1 : 1 to receive 2.5 g of oral leucine powder or a matching placebo powder taken thrice daily with meals. Randomisation was performed using an interactive web-based randomisation system run independently of the research team to preserve allocation concealment.</p></div><div id="abs1-7"><h4 class="inline">Main outcome measures:</h4><p>The primary outcome was the between-group difference in the Short Physical Performance Battery (<a href="/books/n/ukeme0908/g1/#g1-def32">SPPB</a>) score over the 12-month follow-up period. Other outcome measures included appendicular muscle mass, <a href="/books/n/ukeme0908/g1/#g1-def12">EQ-5D</a> (EuroQol-5 Dimensions) quality-of-life score, grip strength, quadriceps strength, 6-minute walk distance, activities of daily living, hip bone mineral density and insulin resistance. All adverse events and falls were recorded. Protein-, DNA (deoxyribonucleic acid)- and <a href="/books/n/ukeme0908/g1/#g1-def29">RNA</a> (ribonucleic acid)-based biomarkers were collected at baseline and at 3 and 12 months.</p></div><div id="abs1-8"><h4 class="inline">Results:</h4><p>We screened 320 people and randomised 145 participants. Participants had a mean age of 79 (standard deviation 6) years, 78 (54%) were women and the mean <a href="/books/n/ukeme0908/g1/#g1-def32">SPPB</a> was 7.0 (standard deviation 2.4). The median adherence was lower for perindopril than for placebo (76% vs. 96%; <i>p</i> < 0.001). Perindopril did not improve the primary outcome (adjusted treatment effect –0.1 points, 95% confidence interval –1.2 to 1.0 points). Quality of life was worse in the perindopril group (treatment effect –12 points, 95% confidence interval –21 to –3 points) and more adverse events occurred in the perindopril group (<i>n</i> = 218 vs. <i>n</i> = 165). Falls rates between the groups were similar and other secondary outcomes showed no significant treatment effect. For leucine compared with placebo, median adherence was the same in both groups (76% vs. 76%; <i>p</i> = 0.99). Leucine did not improve the primary outcome (adjusted treatment effect 0.1 point, 95% confidence interval –1.0 to 1.1 points). No significant treatment effect was found for any secondary outcome. There were similar numbers of adverse events and falls in both groups.</p></div><div id="abs1-9"><h4 class="inline">Limitations:</h4><p>The trial did not reach its original recruitment target; this trial alone cannot confidently exclude clinically important effects of either perindopril or leucine.</p></div><div id="abs1-10"><h4 class="inline">Future work:</h4><p>Further exploration of biomarkers predicting response to sarcopenia interventions is warranted.</p></div><div id="abs1-11"><h4 class="inline">Conclusions:</h4><p>Neither perindopril nor leucine improved physical performance or muscle mass in this trial; meta-analysis confirmed the lack of efficacy of both treatments in improving physical performance.</p></div><div id="abs1-12"><h4 class="inline">Study registration:</h4><p>This trial is registered as ISRCTN90094835 and EudraCT 2014-003455-61. The systematic review is registered as PROSPERO CRD42014013398.</p></div><div id="abs1-13"><h4 class="inline">Funding:</h4><p>This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and National Institute for Health and Care Research (<a href="/books/n/ukeme0908/g1/#g1-def27">NIHR</a>) partnership. This will be published in full in <i>Efficacy and Mechanism Evaluation</i>; Vol. 9, No. 8. See the <a href="/books/n/ukeme0908/g1/#g1-def27">NIHR</a> Journals Library website for further project information.</p></div></div><div><h2>Contents</h2><div class="bktoc_all_cntnr top align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div><ul id="toc_tllNBK583341_toc_abs2" class="simple-list toc toc-toggle"><li class="half_rhythm" id="toc_itm_NBK583341_toc_abs2"><a class="toc-item" href="/books/n/ukeme0908/abs2/">Plain English summary</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_abs3"><a class="toc-item" href="/books/n/ukeme0908/abs3/">Scientific summary</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s1"><a class="toc-item" href="/books/n/ukeme0908/s1/">Chapter 1. Introduction</a><ul id="toc_lst_NBK583341_toc_s1" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s1-1"><a class="toc-item" href="/books/n/ukeme0908/s1/#s1-1">Background to and rationale for the trial</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s1-2"><a class="toc-item" href="/books/n/ukeme0908/s1/#s1-2">Rationale for the use of leucine</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s1-3"><a class="toc-item" href="/books/n/ukeme0908/s1/#s1-3">Rationale for the use of angiotensin-converting enzyme inhibitor drugs</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s1-4"><a class="toc-item" href="/books/n/ukeme0908/s1/#s1-4">Imperative for the current trial</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s2"><a class="toc-item" href="/books/n/ukeme0908/s2/">Chapter 2. Trial design</a><ul id="toc_lst_NBK583341_toc_s2" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s2-1"><a class="toc-item" href="/books/n/ukeme0908/s2/#s2-1">Participants</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s2-2"><a class="toc-item" href="/books/n/ukeme0908/s2/#s2-2">Trial interventions and comparators</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s2-3"><a class="toc-item" href="/books/n/ukeme0908/s2/#s2-3">Outcome measures</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s2-4"><a class="toc-item" href="/books/n/ukeme0908/s2/#s2-4">Sample size calculation</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3"><a class="toc-item" href="/books/n/ukeme0908/s3/">Chapter 3. Trial methods</a><ul id="toc_lst_NBK583341_toc_s3" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-1"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-1">Regulatory approval</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-2"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-2">Participants</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-3"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-3">Randomisation and treatment allocation</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-4"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-4">Interventions and comparators</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-5"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-5">Outcomes measurement</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-6"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-6">Data management</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-7"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-7">Safety reporting</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-8"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-8">Trial oversight committees</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-9"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-9">Role of patient and public involvement</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-10"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-10">Important changes to the trial design and conduct after trial commencement</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-11"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-11">Statistical analysis</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-12"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-12">Review of existing trial evidence: systematic review methods</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-13"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-13">Leucine meta-analysis methods</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s3-14"><a class="toc-item" href="/books/n/ukeme0908/s3/#s3-14">Analysis of biomarker blood samples and data</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4"><a class="toc-item" href="/books/n/ukeme0908/s4/">Chapter 4. Screening and recruitment methods results</a><ul id="toc_lst_NBK583341_toc_s4" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-1"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-1">Focus of chapter</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-2"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-2">Recruitment</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-3"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-3">Results</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-4"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-4">Derivation of an alternative equation to estimate muscle mass from bioimpedance</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-5"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-5">Ability of recruitment process to deliver a study population meeting the definition of sarcopenia</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s4-6"><a class="toc-item" href="/books/n/ukeme0908/s4/#s4-6">Summary of results</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5"><a class="toc-item" href="/books/n/ukeme0908/s5/">Chapter 5. Main trial results: perindopril versus placebo</a><ul id="toc_lst_NBK583341_toc_s5" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5-1"><a class="toc-item" href="/books/n/ukeme0908/s5/#s5-1">Adherence</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5-2"><a class="toc-item" href="/books/n/ukeme0908/s5/#s5-2">Primary outcome analysis</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5-3"><a class="toc-item" href="/books/n/ukeme0908/s5/#s5-3">Secondary outcomes</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5-4"><a class="toc-item" href="/books/n/ukeme0908/s5/#s5-4">Safety measures and adverse events</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s5-5"><a class="toc-item" href="/books/n/ukeme0908/s5/#s5-5">Meta-analysis of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker trials</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6"><a class="toc-item" href="/books/n/ukeme0908/s6/">Chapter 6. Main trial results: leucine versus placebo</a><ul id="toc_lst_NBK583341_toc_s6" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6-1"><a class="toc-item" href="/books/n/ukeme0908/s6/#s6-1">Adherence</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6-2"><a class="toc-item" href="/books/n/ukeme0908/s6/#s6-2">Primary outcome analysis</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6-3"><a class="toc-item" href="/books/n/ukeme0908/s6/#s6-3">Secondary outcomes</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6-4"><a class="toc-item" href="/books/n/ukeme0908/s6/#s6-4">Adverse events</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s6-5"><a class="toc-item" href="/books/n/ukeme0908/s6/#s6-5">Meta-analysis of leucine trials</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s7"><a class="toc-item" href="/books/n/ukeme0908/s7/">Chapter 7. Biomarker studies</a><ul id="toc_lst_NBK583341_toc_s7" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s7-1"><a class="toc-item" href="/books/n/ukeme0908/s7/#s7-1">Focus of chapter</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s7-2"><a class="toc-item" href="/books/n/ukeme0908/s7/#s7-2">Association between baseline biomarkers and baseline muscle measures</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s7-3"><a class="toc-item" href="/books/n/ukeme0908/s7/#s7-3">Association between baseline biomarkers and change in muscle measures over time</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s7-4"><a class="toc-item" href="/books/n/ukeme0908/s7/#s7-4">Association between short-term change in biomarkers and change in muscle measures over time</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s8"><a class="toc-item" href="/books/n/ukeme0908/s8/">Chapter 8. Discussion</a><ul id="toc_lst_NBK583341_toc_s8" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s8-1"><a class="toc-item" href="/books/n/ukeme0908/s8/#s8-1">Key findings</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s8-2"><a class="toc-item" href="/books/n/ukeme0908/s8/#s8-2">Results in context</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s8-3"><a class="toc-item" href="/books/n/ukeme0908/s8/#s8-3">Strengths</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s9"><a class="toc-item" href="/books/n/ukeme0908/s9/">Chapter 9. Conclusions</a><ul id="toc_lst_NBK583341_toc_s9" class="simple-list toc bktoc_lst_exp"><li class="half_rhythm" id="toc_itm_NBK583341_toc_s9-1"><a class="toc-item" href="/books/n/ukeme0908/s9/#s9-1">Implications for health care</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_s9-2"><a class="toc-item" href="/books/n/ukeme0908/s9/#s9-2">Suggestions for further research</a></li></ul></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_ack1"><a class="toc-item" href="/books/n/ukeme0908/ack1/">Acknowledgements</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_ref1"><a class="toc-item" href="/books/n/ukeme0908/ref1/">References</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_app1"><a class="toc-item" href="/books/n/ukeme0908/app1/">Appendix 1. Recruitment by site</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_app2"><a class="toc-item" href="/books/n/ukeme0908/app2/">Appendix 2. Overall recruitment rates</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_app3"><a class="toc-item" href="/books/n/ukeme0908/app3/">Appendix 3. Derivation of an alternative prediction equation for muscle mass using bioimpedance data</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_app4"><a class="toc-item" href="/books/n/ukeme0908/app4/">Appendix 4. Systematic review of / results</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_app5"><a class="toc-item" href="/books/n/ukeme0908/app5/">Appendix 5. Genotyping analyses</a></li><li class="half_rhythm" id="toc_itm_NBK583341_toc_g1"><a class="toc-item" href="/books/n/ukeme0908/g1/">List of abbreviations</a></li></ul><div class="bktoc_all_cntnr align_right" style="display:none"><ul class="inline_list_right"><li><a class="bktoc_all_exp" href="#">Expand All</a></li><li style="margin-left:.8em"><a class="bktoc_all_clps" href="#">Collapse All</a></li></ul></div></div><div class="pmc_boxed-text-box fm-sec whole_rhythm"><h3>About the Series</h3><div class="half_rhythm"><div>Efficacy and Mechanism Evaluation</div></div><div class="half_rhythm"><div>ISSN (Print): 2050-4365</div><div>ISSN (Electronic): 2050-4373</div></div></div><div><p>Declared competing interests of authors: Peter T Donnan is a member of the New Drugs Committee of the Scottish Medicines Consortium and reports a recent grant from AbbVie Pharmaceuticals (Maidenhead, UK). Miles D Witham is a member of the National Institute for Health and Care Research Health Technology Assessment Prioritisation Committee A (Out of Hospital) (November 2020–present).</p></div><div><div id="n1-1"><h2>Article history</h2><p>The research reported in this issue of the journal was funded by the EME programme as project number 13/53/03. The contractual start date was in November 2015. The final report began editorial review in May 2021 and was accepted for publication in September 2021. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The EME editors and production house have tried to ensure the accuracy of the authors’ report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.</p></div></div><p class="small">Last reviewed: May 2021; Accepted: September 2021.</p></div></div>
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK583341/?report=reader">PubReader</a></li><li><a href="/books/NBK583341/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK583341" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK583341" style="display:none" title="Cite this Page"><div class="bk_tt">Witham MD, Adamson S, Avenell A, et al. Leucine and perindopril to improve physical performance in people over 70 years with sarcopenia: the LACE factorial RCT. Southampton (UK): National Institute for Health and Care Research; 2022 Aug. (Efficacy and Mechanism Evaluation, No. 9.8.)<span class="bk_cite_avail"></span> doi: 10.3310/LLBX6901</div></div></li><li><a href="/books/n/ukeme0908/pdf/">PDF version of this title</a> (1.9M)</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Other titles in this collection</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/ukemecollect/">Efficacy and Mechanism Evaluation</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=nlmcatalog&DbFrom=books&Cmd=Link&LinkName=books_nlmcatalog&IdsFromResult=5358986" ref="log$=recordlinks">NLM Catalog</a><div class="brieflinkpop offscreen_noflow">Related NLM Catalog Entries</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/35174663" ref="ordinalpos=1&linkpos=1&log$=relatedarticles&logdbfrom=pubmed">Effect of perindopril or leucine on physical performance in older people with sarcopenia: the LACE randomized controlled trial.</a><span class="source">[J Cachexia Sarcopenia Muscle. ...]</span><div class="brieflinkpop offscreen_noflow">Effect of perindopril or leucine on physical performance in older people with sarcopenia: the LACE randomized controlled trial.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">LACE study group, Achison M, Adamson S, Akpan A, Aspray T, Avenell A, Band MM, Bashir T, Burton LA, Cvoro V, et al. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">J Cachexia Sarcopenia Muscle. 2022 Apr; 13(2):858-871. 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