Comparing Inclisiran Versus Statin for Primary Aldosteronism

November 10, 2026 updated by: Zhiming Zhu, Third Military Medical University

A Randomized Controlled Study Comparing Inclisiran Plus Spironolactone Versus Statin Plus Spironolactone for Primary Aldosteronism

Primary aldosteronism represents one of the leading causes of resistant hypertension. Circulating cholesterol is established as the exclusive substrate for adrenal aldosterone synthesis, and statins, which suppress cholesterol production, are currently widely applied in clinical settings. Emerging clinical evidence has demonstrated that in patients with essential hypertension, the plasma aldosterone level decreased by 43% (from 13.9 ng/dL to 7.9 ng/dL) after treatment with PCSK9 inhibitors. However, the effect of PCSK9 inhibitors with superior lipid-lowering efficacy combined with amlodipine besylate on aldosterone levels remains elusive. The present clinical trial adopted inclisiran, a PCSK9 inhibitor with well-documented clinical safety and robust lipid-lowering effects, in combination with amlodipine besylate. Through randomized grouping intervention and follow-up, this study aimed to compare the differential effects of two therapeutic regimens-inclisiran-based therapy and statin-based therapy-on plasma aldosterone levels, as well as improvements in a spectrum of clinical parameters including blood pressure , serum potassium and so on in patients with primary aldosteronism. The outcomes of this trial are expected to provide novel and more effective pharmacological strategies for the management of primary aldosteronism.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

50

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Zhiming Zhu

Study Locations

    • Chongqing Municipality
      • Chongqing, Chongqing Municipality, China, 400042
        • Recruiting
        • Daping Hospital,Third Military Medical University
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Patients with hypertension aged18-70years.
  2. Meeting the diagnostic criteria for primary aldosteronism (PA) according to the *Expert Consensus on the Diagnosis and Treatment of Primary Aldosteronism (2025 Edition)
  3. Patients either untreated or on antihypertensive therapy; after a 1-2week washout period, blood pressure is <160/100mmHg.
  4. Serum potassium at the end of the run-in period: 3mmol/L ≤ serum potassium <5mmol/L.
  5. Voluntary participation in the trial and provision of written informed consent.

Exclusion Criteria:

  1. Office blood pressure >180/110mmHg.
  2. Severe hepatic insufficiency or severe renal insufficiency.
  3. Acute coronary syndrome, myocardial infarction, percutaneous coronary intervention, or cerebrovascular accident within the previous 6 months; heart failure of NYHA class II-IV.
  4. Serum potassium <2.5mmol/L or >5.5mmol/L.
  5. Pregnancy or planned pregnancy within 1year.
  6. Neurological or psychiatric disorders.
  7. Concurrent malignant neoplasm.
  8. Low-density-lipoprotein-cholesterol(LDL-C) <2.6mmol/L.
  9. Any other conditions that, in the investigator's opinion, may interfere with efficacy and/or safety assessment of the study (including but not limited to poor subject compliance or inability to attend scheduled follow-up due to long-distance residence).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Subcutaneous inclisiran plus oral amlodipine besylate and spironolactone

Participants receive inclisiran 284 mg subcutaneously (initial dose, repeat at 3 months) plus oral amlodipine besylate 5 mg once daily and oral spironolactone 20 mg once daily.

Subcutaneous inclisiran

oral Spironolactone

oral Amlodipine besylate

Placebo Comparator: Statin plus amlodipine besylate and spironolactone

Participants receive oral simvastatin 40 mg, oral amlodipine besylate 5 mg once daily, and oral spironolactone 20 mg once daily.

oral Spironolactone

oral Amlodipine besylate

oral Lipophilic statins (such as Simvastatin, Atorvastatin, Fluvastatin, Lovastatin,Pitavastatin)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Change from baseline in plasma aldosterone level
Time Frame: 24 weeks after randomization
24 weeks after randomization

Secondary Outcome Measures

Outcome Measure
Time Frame
Change from baseline in systolic and diastolic blood pressure
Time Frame: 24 weeks after randomization
24 weeks after randomization
Change from baseline in plasma renin concentration
Time Frame: 24 weeks after randomization
24 weeks after randomization
Change from baseline in 24-hour urinary aldosterone
Time Frame: 24 weeks after randomization
24 weeks after randomization
Change from baseline in serum potassium level
Time Frame: 24 weeks after randomization
24 weeks after randomization
Change from baseline in plasma lipid
Time Frame: 24 weeks after randomization
24 weeks after randomization
Change from baseline in glucose
Time Frame: 24 weeks after randomization
24 weeks after randomization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

November 15, 2026

Primary Completion (Estimated)

August 1, 2027

Study Completion (Estimated)

August 1, 2027

Study Registration Dates

First Submitted

October 13, 2026

First Submitted That Met QC Criteria

October 13, 2026

First Posted (Actual)

October 21, 2026

Study Record Updates

Last Update Posted (Actual)

November 12, 2026

Last Update Submitted That Met QC Criteria

November 10, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.