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NCT04331691Befejeződött4. fázis

Comparison of Spironolactone and Amiloride on Home Blood Pressure in Resistant Hypertension

SPironolactone Versus Amiloride for Treatment of REsistant Hypertension (SPARE Trial): A Comparison of Home Blood Pressure

Forrás: ClinicalTrials.gov · Utoljára frissítve: 2024. szept. 24.

Következő lépések

Rövid összefoglaló (regiszter, angolul)

Resistant hypertension is defined as blood pressure that remains above goal despite concurrent use of three antihypertensive agents of different classes including diuretics. Patients with resistant hypertension has at least 1.5-fold higher cardiovascular risk than those with non-resistant hypertension. Therefore, controlling blood pressure is crucial in patients with resistant hypertension. It has been unclear which antihypertensive agent should be added in patients who cannot reach target blood pressure despite use of three antihypertensive agents. There have been three randomized clinical trials that proved the efficacy of spironolactone in resistant hypertension, but they were small sized, comparison study to placebo. Recently published PATHWAY-2 study which compared the efficacy of spironolactone with placebo, doxazosin, and bisoprolol showed superiority of spironolactone in blood pressure lowering in patients with resistant hypertension. Thus, revised ACC/AHA and ESC/ESH guideline for arterial hypertension recommended spironolactone as the fourth agent for resistant hypertension. However, in real world, adherence to spironolactone may not be adequate because of adverse effect such as gynecomastia, hyperkalemia, and so on. Recently, sub-study of PATHWAY-2 revealed that amiloride changes systolic blood pressure by -22.2 mmHg (95% CI, -24.7 to -19.7) which is comparable with the effect of spironolactone (-21.8 mmHg; 95% CI, -24.2 to -19.3). However, it was not randomized clinical trial to compare the effect between spironolactone and amiloride in patients with resistant hypertension. This study aims to compare the effect of spironolactone and amiloride on home blood pressure in resistant hypertensive patients and to compare the rate of target blood pressure achievement between spironolactone and amiloride in resistant hypertensive patients.

Állapot (regiszter)
Befejeződött
Fázis (regiszter)
4. fázis
Vizsgálattípus
Beavatkozással járó
Résztvevők száma
118 (tényleges)
Első benyújtás
2020. márc. 31.
Kezdés
2020. nov. 16.
Elsődleges befejezés
2024. máj. 23.
Fő szponzor
Yonsei University
NCT-szám
NCT04331691

Mit vállalsz

  • Vizsgálat típusa: Beavatkozással járó · 4. fázis
  • Bevont résztvevők: 118
  • 2020. nov. 16. és az elsődleges befejezés (2024. máj. 23.) között
  • 1 helyszín, 1 országban
  • Vizitek és vizsgálatok: kérdezd a vizsgálat csapatát, a regiszter nem sorolja fel őket

A(z) ClinicalTrials.gov regisztermezőiből összeállítva. A vizsgálat felépítését írja le.

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Korábbi kezelés

  • Known cardiovascular disease (including stroke and TIA), including a history of angina, heart failure, myocardial infarction or revascularization, or cerebrovascular disease prior to 6 months
  • Intolerant to test drug/drug group or its components
  • Subjects who are currently participating in other clinical trials and who have taken other investigational product within the past month.
  • The combination of medications known to affect blood pressure, except those permitted by the protocol.
  • Other clinical conditions that, as determined by the investigator, cannot be safely completed according to the protocol or that the investigational product cannot be safely used a history of secondary hypertension that cannot be corrected

Más betegség

  • White-coat uncontrolled hypertension
  • Severe hypertension (WHO classification criteria grade 3 average diastolic blood pressure ≥ 110 mmHg or average systolic blood pressure ≥ 180 mmHg)
  • Congestive heart failure of III-IV according to NYHA functional classification
  • Clinically meaningful ventricular tachycardia, atrial fibrillation, atrial flutter, or other arrhythmia that the investigator has deemed clinically meaningful.
  • Hypertrophic obstructive cardiomyopathy, severe obstructive coronary artery disease, aortic stenosis, hemodynamically significant aortic valve or stenosis on the mitral valve
  • Gastrointestinal diseases that can cause potential malabsorption the gastro-intestinal tract is severely narrowed; Kock pouch (a continent pouch formed by the terminal ileum after colectomy)
  • Subjects who have condition or a disease that may impede the completion of the test, according to the investigator's opinion
  • History of drug or alcohol dependence within 6 months

Laborértékek

  • Renal insufficiency (basal estimated glomerular filtration rate (eGFR) <50 ml / min / 1.73m2)
  • liver disease or aspartate aminotransferase (AST) / alanine aminotransferase (ALT) levels > 2-fold the normal upper limit (ULN)
  • Uncorrected sodium or fluid depletion

Egyéb

  • Hyperkalemia (> 5.0 mmol / L, which can be reconfirmed if errors are suspected in the results)
  • Bile stasis or biliary obstruction
  • Pregnant or fertile women who are not contraceptive or woman who are lactating
  • If assigned to treatment for this trial in the past
  • Taking spironolactone or amiloride within 4 weeks from the time of screening
  • If discontinued due to side effects of spironolactone or amiloride

Kiket keres a vizsgálat

  • Age 19-75
  • Patients with resistant hypertension
    • 1st screening: ven while taking three or more types of antihypertensive medications including diuretics without changing the dose for 1 month, the average office systolic blood pressure measured in three times is 130-180 mmHg and daytime systolic blood pressure is ≥130 mmHg.
    • 2nd screening: An average systolic blood pressure of home blood pressure monitoring is ≥130 mmHg during the run-in period of antihypertensive drugs including diuretics (Sevikar HCT 5/20/12.5 mg, 5/40/12.5 mg or 10/40/12.5 mg).
  • Patients with resistant hypertension who have agreed to participate in the study: when they have the ability to write a written consent in accordance with the Korean Good Clinical Practice (KGCP) and local laws.
  • Patients who can change the currently used antihypertensive treatment to Sevikar HCT 5/20/12.5 mg, 5/40/12.5 mg or 10/40/12.5 mg without giving unacceptable risk (investigator's judgment)

Életkor a regiszterben: 19 év – 75 év · Nem: nők és férfiak · Egészséges önkénteseket nem fogad

A teljes feltétellista: ClinicalTrials.gov

Helyszínek (1)

Helyszínek a regiszter sorrendjében. Ha a profilodba mented a városodat, távolság szerint rendeződnek.

HelyszínVárosOrszágHelyszín állapota
Severance Cardiovascular Hospital, Yonsei University Health SystemSeoulDél-KoreaIsmeretlen állapot

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