Comparing Inclisiran Versus Statin for Primary Aldosteronism
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.
調査の概要
状態
条件
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前:Liyuan Yuan
- 電話番号:+8617374960635
- メール:706539967@qq.com
研究連絡先のバックアップ
- 名前:Zhiming Zhu
研究場所
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Chongqing Municipality
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Chongqing、Chongqing Municipality、中国、400042
- 募集
- Daping Hospital,Third Military Medical University
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コンタクト:
- Zhiming Zhu
- 電話番号:+8613608313322
- メール:hbpcms@sina.com
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Patients with hypertension aged18-70years.
- Meeting the diagnostic criteria for primary aldosteronism (PA) according to the *Expert Consensus on the Diagnosis and Treatment of Primary Aldosteronism (2025 Edition)
- Patients either untreated or on antihypertensive therapy; after a 1-2week washout period, blood pressure is <160/100mmHg.
- Serum potassium at the end of the run-in period: 3mmol/L ≤ serum potassium <5mmol/L.
- Voluntary participation in the trial and provision of written informed consent.
Exclusion Criteria:
- Office blood pressure >180/110mmHg.
- Severe hepatic insufficiency or severe renal insufficiency.
- Acute coronary syndrome, myocardial infarction, percutaneous coronary intervention, or cerebrovascular accident within the previous 6 months; heart failure of NYHA class II-IV.
- Serum potassium <2.5mmol/L or >5.5mmol/L.
- Pregnancy or planned pregnancy within 1year.
- Neurological or psychiatric disorders.
- Concurrent malignant neoplasm.
- Low-density-lipoprotein-cholesterol(LDL-C) <2.6mmol/L.
- 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).
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的: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 |
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プラセボコンパレーター: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) |
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
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Change from baseline in plasma aldosterone level
時間枠:24 weeks after randomization
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24 weeks after randomization
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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Change from baseline in systolic and diastolic blood pressure
時間枠:24 weeks after randomization
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24 weeks after randomization
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Change from baseline in plasma renin concentration
時間枠:24 weeks after randomization
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24 weeks after randomization
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Change from baseline in 24-hour urinary aldosterone
時間枠:24 weeks after randomization
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24 weeks after randomization
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Change from baseline in serum potassium level
時間枠:24 weeks after randomization
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24 weeks after randomization
|
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Change from baseline in plasma lipid
時間枠:24 weeks after randomization
|
24 weeks after randomization
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Change from baseline in glucose
時間枠:24 weeks after randomization
|
24 weeks after randomization
|
協力者と研究者
出版物と役立つリンク
一般刊行物
- Baudrand R, Pojoga LH, Vaidya A, Garza AE, Vohringer PA, Jeunemaitre X, Hopkins PN, Yao TM, Williams J, Adler GK, Williams GH. Statin Use and Adrenal Aldosterone Production in Hypertensive and Diabetic Subjects. Circulation. 2015 Nov 10;132(19):1825-33. doi: 10.1161/CIRCULATIONAHA.115.016759. Epub 2015 Oct 2.
- Wu H, He H, Han T, Tian X, Zhu Z. Targeting cholesterol-dependent adrenal steroidogenesis for management of primary aldosteronism. Trends Endocrinol Metab. 2025 Sep;36(9):789-801. doi: 10.1016/j.tem.2024.12.001. Epub 2025 Jan 6.
- Izkhakov E, Shacham Y, Serebro M, Yaish I, Marcus Y, Shefer G, Tordjman K, Greenman Y, Stern N, Ziv-Baran T. The Effect of the PCSK9 Inhibitor Evolocumab on Aldosterone Secretion among High Cardiovascular Risk Patients: A Pilot Study. J Clin Med. 2021 Jun 5;10(11):2504. doi: 10.3390/jcm10112504.
- Navarese EP, Kolodziejczak M, Schulze V, Gurbel PA, Tantry U, Lin Y, Brockmeyer M, Kandzari DE, Kubica JM, D'Agostino RB Sr, Kubica J, Volpe M, Agewall S, Kereiakes DJ, Kelm M. Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Antibodies in Adults With Hypercholesterolemia: A Systematic Review and Meta-analysis. Ann Intern Med. 2015 Jul 7;163(1):40-51. doi: 10.7326/M14-2957.
- Capponi AM. Regulation of cholesterol supply for mineralocorticoid biosynthesis. Trends Endocrinol Metab. 2002 Apr;13(3):118-21. doi: 10.1016/s1043-2760(01)00538-0.
研究記録日
主要日程の研究
研究開始 (推定)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
追加の関連 MeSH 用語
その他の研究ID番号
- ISPA
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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