Evaluating the clinical and mechanistic effects of eplerenone and amiloride monotherapy, and combination therapy with cinacalcet, in primary hyperparathyroidism: A placebo‐controlled randomized trial
Authors' conclusion
Although maximally tolerated therapy with eplerenone and amiloride induced expected changes in renin, aldosterone and blood pressure, there were no meaningful changes in PTH or serum calcium levels in P-HPT patients. These results suggest that inhibition of aldosterone action does not have a clinically meaningful role in medical therapy for P-HPT.
Study context
- Population
- Patients with primary hyperparathyroidism (P-HPT); most women (83%) and White (76%)
- Comparison
- Eplerenone vs amiloride vs placebo for 4 weeks, then each combined with cinacalcet for 2 weeks
- Primary endpoint
- PTH levels
- Follow-up
- 4 weeks
Methodological detailsdouble-blinded, three parallel-group, placebo-controlled
- Double-blinded
- Three parallel-group
- Placebo-controlled
Primary result
As reported in the abstract
PTH and calcium levels
- Neither eplerenone nor amiloride induced significant changes in parathyroid hormone (PTH) or calcium levels vs placebo
Further findings
Blood pressure, renin and aldosterone
- Eplerenone and amiloride induced significant reductions in blood pressure and increases in renin and aldosterone production
Procollagen type 1 N-terminal propeptide
- Both eplerenone and amiloride induced significant reductions in procollagen type 1 N-terminal propeptide vs placebo
PTH and serum calcium with added cinacalcet · additional 2 weeks
- PTH and calcium markedly reduced in all groups; no significant difference in PTH or serum calcium reductions between groups
Original publication
Evaluating the clinical and mechanistic effects of eplerenone and amiloride monotherapy, and combination therapy with cinacalcet, in primary hyperparathyroidism: A placebo‐controlled randomized trial. Clin Endocrinol (Oxf). Published 8 November 2022. doi:10.
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