About this trial
Using spironolactone as the control, to assess the efficacy and safety of finerenone in patients with primary aldosteronism(PA).
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
. Aged between 18-75, male or female;
. With confirmed PA diagnosis (screening positive and at least one confirmatory test is positive); NOTE: Screening positive was defined as plasma aldosterone-to-renin ratio (ARR)
. Not taking any antihypertensive drugs or on a stable regimen of antihypertensive agents(Limited to alpha-adrenergic receptor blockers and calcium channel blockers.) for more than four weeks before screening;
. With a mean seated office SBP≥140 or DBP≥90 mmHg;
Disqualifiers
Has a plan to conduct PA subtype classification(eg. Adrenal vein sampling, PET-CT) in 3 months;
Has planned surgery within 3 months;
With a mean seated office SBP ≥ 180mmHg or DBP ≥ 110mmHg before randomization; Note: Mean seated BP is defined as the average of 3 seated BP measurements at any single clinical site visit. If the patient did not take their regularly scheduled antihypertensive medications prior to the visit, 1 BP re-test is allowed within 2 days after taking the medications.
Night shift workers;
Trial design
Parallel
Treatments tested in this trial
Finerenone Oral Tablet
DrugEligible patients will be started finerenone at 20mg per day, Dose will be adjusted every four weeks to achieve the targeted blood pressure (the mean office blood pressure \<140/90 mmHg).
Spironolactone Oral Tablet
DrugEligible patients will be started spironolactone at 20mg per day, Dose will be adjusted every four weeks to achieve the targeted blood pressure (the mean office blood pressure \<140/90 mmHg).
Treatment groups
Trial outcomes
Primary outcomes
Change from baseline in 24-hour SBP
Change from baseline in 24-hour systolic blood pressure (SBP) assessed by 24-hour ambulatory blood pressure monitoring compared to spironolactone after 12 weeks of finerenone therapy in patients with PA.
Secondary outcomes
Change from baseline in 24-hour DBP
Change from baseline in 24-hour diastolic blood pressure (DBP) assessed by 24-hour ambulatory blood pressure monitoring compared to spironolactone after 12 weeks of finerenone therapy in patients with PA.
Change from baseline in daytime SBP
Change from baseline in daytime systolic blood pressure (SBP) assessed by 24-hour ambulatory blood pressure monitoring compared to spironolactone after 12 weeks of finerenone therapy in patients with PA.
Change from baseline in daytime DBP
Change from baseline in daytime diastolic blood pressure (DBP) assessed by 24-hour ambulatory blood pressure monitoring compared to spironolactone after 12 weeks of finerenone therapy in patients with PA.
Change from baseline in nighttime SBP
Change from baseline in nighttime systolic blood pressure (SBP) assessed by 24-hour ambulatory blood pressure monitoring compared to spironolactone after 12 weeks of finerenone therapy in patients with PA.
Other outcomes
Proportion of subjects with AEs
Adverse events(AEs) defined as any untoward medical occurrence in a clinical investigation that occurs to a patient administered a pharmaceutical product, which does not necessarily have a causal relationship with this treatment.
Proportion of subjects with SAEs and AEs leading to discontinuation of treatment with study drug
Serious adverse events(SAEs) results in any of the following outcomes:Death;A life-threatening AE;Requires hospitalization or prolongation of existing hospitalizations;A persistent or significant disability/incapacity or substantial disruption of the ability to conduct normal life functions.
Change in eGFR from baseline.
Blood was drawn to measure eGFR(mL/min/1.73m2)
Change from baseline in urinary albumin-to-creatinine ratio(UACR)
Urine will be collected to measure UACR
Sponsors and contacts
Click on the lead sponsor to view all of their trials.
Qifu Li
Lead sponsor
Chongqing Medical University
Sponsor institution
The Affiliated Hospital Of Southwest Medical University
Collaborator
The First Affiliated Hospital of Zhengzhou University
Collaborator
Second Affiliated Hospital, School of Medicine, Zhejiang University
Collaborator
Changzhi Medical College
Collaborator