Aldosterone antagonist: Difference between revisions
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===Heart failure=== | ===Heart failure=== | ||
* [[Heart failure]] | * [[Heart failure]] | ||
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|+ [[Randomized controlled trial]]s of aldosterone antagonist for [[heart failure]]. | |||
! rowspan="2"|Trial!!rowspan="2"| Patients!!rowspan="2"| Intervention!!rowspan="2"|Comparison !!rowspan="2"|Outcome!!colspan="3"|Results | |||
|-<br/> | |||
! Intervention!!Control!! | |||
|- | |||
| EMPHASIS-HF<ref name="pmid21073363">{{cite journal| author=Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H et al.| title=Eplerenone in patients with systolic heart failure and mild symptoms. | journal=N Engl J Med | year= 2011 | volume= 364 | issue= 1 | pages= 11-21 | pmid=21073363 | doi=10.1056/NEJMoa1009492 | pmc= | url= }} </ref><br/>2010|| cell|| [[eplerenone]] up to 50 mg/day||Placebo|| cell|| cell|| cell|| | |||
|- | |||
| EPHESUS<ref name="pmid12668699">{{cite journal| author=Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B et al.| title=Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. | journal=N Engl J Med | year= 2003 | volume= 348 | issue= 14 | pages= 1309-21 | pmid=12668699 | doi=10.1056/NEJMoa030207 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12668699 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12899810 Review in: J Fam Pract. 2003 Aug;52(8):598-9] [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12954024 Review in: ACP J Club. 2003 Sep-Oct;139(2):32] </ref><br/>2003|| 6642 patients<br/>• < 2 weeks after [[myocardial infarction]]• < 40 percent ejection fraction|| [[eplerenone]] up to 50 mg/day||Placebo|| mortality at 24 months|| 14%|| 17%|| P=0.008 | |||
|- | |||
| RALES<ref name="pmid10471456">{{cite journal| author=Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A et al.| title=The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 10 | pages= 709-17 | pmid=10471456 | doi=10.1056/NEJM199909023411001 | pmc= | url= }} </ref><br/>1999|| cell|| [[spironolactone]] 25 mg/day||Placebo|| cell|| cell|| cell|| | |||
|} | |||
==Side effects== | ==Side effects== | ||
Revision as of 13:12, 4 February 2011
In pharmacology, aldosterone antagonists are "compounds which inhibit or antagonize the biosynthesis or actions of aldosterone."[1] Their actions affect the larger renin-angiotensin system.
Examples include:
- Canrenone
- Drospirenone
- Eplerenone
- Spironolactone
Uses
- Ascites
- Chronic kidney disease[2]
- Hirsutism[3]
- Hypertension
- Prevention of hypokalemia caused by thiazide diuretic therapy
Heart failure
| Trial | Patients | Intervention | Comparison | Outcome | Results | ||
|---|---|---|---|---|---|---|---|
| Intervention | Control | ||||||
| EMPHASIS-HF[4] 2010 |
cell | eplerenone up to 50 mg/day | Placebo | cell | cell | cell | |
| EPHESUS[5] 2003 |
6642 patients • < 2 weeks after myocardial infarction• < 40 percent ejection fraction |
eplerenone up to 50 mg/day | Placebo | mortality at 24 months | 14% | 17% | P=0.008 |
| RALES[6] 1999 |
cell | spironolactone 25 mg/day | Placebo | cell | cell | cell | |
Side effects
References
- ↑ Anonymous (2024), Aldosterone antagonist (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Navaneethan SD, Nigwekar SU, Sehgal AR, Strippoli GF (2009). "Aldosterone antagonists for preventing the progression of chronic kidney disease.". Cochrane Database Syst Rev (3): CD007004. DOI:10.1002/14651858.CD007004.pub2. PMID 19588415. Research Blogging.
- ↑ Brown J, Farquhar C, Lee O, Toomath R, Jepson RG (2009). "Spironolactone versus placebo or in combination with steroids for hirsutism and/or acne.". Cochrane Database Syst Rev (2): CD000194. DOI:10.1002/14651858.CD000194.pub2. PMID 19370553. Research Blogging.
- ↑ Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Swedberg K, Shi H et al. (2011). "Eplerenone in patients with systolic heart failure and mild symptoms.". N Engl J Med 364 (1): 11-21. DOI:10.1056/NEJMoa1009492. PMID 21073363. Research Blogging.
- ↑ Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B et al. (2003). "Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction.". N Engl J Med 348 (14): 1309-21. DOI:10.1056/NEJMoa030207. PMID 12668699. Research Blogging. Review in: J Fam Pract. 2003 Aug;52(8):598-9 Review in: ACP J Club. 2003 Sep-Oct;139(2):32
- ↑ Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A et al. (1999). "The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators.". N Engl J Med 341 (10): 709-17. DOI:10.1056/NEJM199909023411001. PMID 10471456. Research Blogging.