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| ID | Type | Description | Link |
|---|---|---|---|
| K23HL093214 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Heart, Lung, and Blood Institute (NHLBI) | NIH |
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The purpose of this study is to determine the effects of spironolactone on collagen markers in a large number of patients with pulmonary hypertension. In addition, safety and tolerability of spironolactone, an aldosterone receptor antagonist, in patients with pulmonary arterial hypertension, will be determined.
Pulmonary arterial hypertension (PAH) is an orphan disease characterized by pulmonary artery hypertrophy, and resulting vascular remodeling of involved vessels, often leading to right heart failure. Accumulating evidence from vascular biology, animal models, and therapeutic drug trials suggests significant contributions of the neurohormonal milieu to the disease process, morbidity, and mortality. The renin-angiotensin-aldosterone system (RAAS) is an important neurohormonal pathway that induces collagen synthesis in the myocardium and systemic vasculature. There is paucity of data regarding the contribution of RAAS in the pathogenesis of PAH and the effects of aldosterone blockade in the amelioration of PAH. Thus, the overall goal of this proposal is to investigate the contribution of RAAS to the pathogenesis of PAH, and to explore the effects of an aldosterone blocker, spironolactone, in PAH.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Spironolactone | Experimental | Drug: Spironolactone Drug: Placebo |
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| Placebo | Experimental | Drug: Placebo Drug: Spironolactone |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Spironolactone | Drug | 50 mg po daily of spironolactone for 8 weeks. A cross-over study where each subject will receive spironolactone or placebo in a random order for 8 weeks each. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in biomarker levels in the spironolactone treated as compared to placebo treated group. | 50 participants will be enrolled in a 16-week study, and each subject will receive placebo or active drug in a random order. At the end of week 8, treatment arm for each subject will be blindly switched. Biomarker levels will be drawn 3 times (baseline, week 8, and week 16) during the study period for each subject. | 16 week |
| Measure | Description | Time Frame |
|---|---|---|
| Number of adverse events in patients treated with spironolactone as compared to placebo. | Safety and tolerability of spironolactone as compared to placebo in PAH. | 16 week |
| Change in six-minute walk distance from baseline to week 8 and week 16. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zeenat Safdar, MD | Contact | 713-798-2400 | safdar@bcm.edu | |
| Gwendolyn Goodloe | Contact | 713-798-2400 | gmb@bcm.edu |
| Name | Affiliation | Role |
|---|---|---|
| Zeenat Safdar, MD | Baylor College of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Baylor College of Medicine | Recruiting | Houston | Texas | 77030 | United States |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Sep 4, 2020 | |
| Reset | Sep 28, 2020 | |
| Release | Mar 18, 2026 | |
| Reset | Apr 6, 2026 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Sep 4, 2020 | Sep 28, 2020 | |||
| Mar 18, 2026 |
| ID | Term |
|---|---|
| D006976 | Hypertension, Pulmonary |
| D006333 | Heart Failure |
| D004487 | Edema |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D006973 | Hypertension |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D013148 | Spironolactone |
| D000073893 | Sugars |
| ID | Term |
|---|---|
| D007783 | Lactones |
| D009930 | Organic Chemicals |
| D011283 | Pregnenes |
| D011278 | Pregnanes |
| D013256 |
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| Placebo | Drug | Each subject will receive placebo or spironolactone for 8 weeks. At the end of week 8, treatment arm for each subject will be blindly switched. So if a study patient received placebo for the first 8 weeks then he/she will be switched to receive active drug (spironolactone) for the next 8 weeks. |
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| 16 week |
| Composite end-point | Composite end-point predefined as greater than 10% increase in walk distance, improvement by at least one functional class and absence of clinical worsening. Clinical worsening will be defined as hospitalization for worsening PAH, all-cause death, addition of prostacyclin therapy, lung transplantation, or atrial septostomy. | 16 week |
| Apr 6, 2026 |
| D002318 |
| Cardiovascular Diseases |
| D006331 | Heart Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D002241 | Carbohydrates |