CLINICAL AND PHARMACOLOGICAL FEATURES OF THE USE OF ALDOSTERONE ANTAGONISTS IN PATIENTS WITH HYPERTONIC DISEASE

Authors

  • Valentyna Moyseyenko Bogomolets National Medical University, MD, PhD, Professor
  • Vitaliy Bondur Bogomolets National Medical University
  • Artem Lyubitsky Bogomolets National Medical University 4th year student of the Medical Faculty №2

DOI:

https://doi.org/10.37321/nefrology.2021.29-04

Abstract

Introduction. Arterial hypertension is a widely spread disease with a tendency to year-over-year growth. It causes a number of comorbidities, has a great variety of manifestations and leads to life-threatening complications. In order to facilitate the situation, a lot of pharmacological remedies, were invented. Thus, a constantly aggravating disease needs further impovements in drug administration. Efficacy, economy and safety concerns are the most valuable aspects in terms of patient`s outcome, that`s why they have to be investigated and administered properly to reach the best possible effect.
Goal. Efficacy, specifics and safety concerns comparison of antihypertensive drugs spironolactone and eplerenone.
Materials and methods. Bibliographic – a theoretical analysis is carried out and a generalization of literature data is carried out, the actual content is analyzed. In the study, a questionnaire-survey method was used, as well as description, analysis, abstracting.
Results and discussion. Considering the diseases of urinary system, such as chronic kidney disease and hyperaldosteronism and cardiovascular system, of those, the arterial hypertension, both complicated and not, a greater therapeutic effect was reached in case of eplerenone administration. This drug satisfy the demands of clinicians not just in case of arterial hypertension, but also in case of albuminuria in II type diabetes, chronic kidney disease and hyperaldosteronism. And in terms of arterial hypertension, eplerenone was considered just as effective and more safe, comparing with spironolactone. Pharmacokinetics of eplerenone allow it to be much more specific to mineralocorticoid receptor blockade. With the whole picture realised, eplerenone has a great opportunities to compete with other drugs in treating states and diseases mentioned in this article.
Conclusion. Analyzing plenty of investigations, eplerenone can be recognized more safe and equally effective, comparing with spironolactone.

Downloads

Download data is not yet available.

References

1. https://compendium.com.ua/uk/tutorials-uk/vnutrishnya-meditsina/2-rozdil-zakhvoriuvanniasertsia-ta-sudyn/2-3-gipertonichna-hvoroba/
2. Mills K. T., Stefanescu A., & He J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology. doi:10.1038/s41581- 019-0244-2
3. https://www.dec.gov.ua/wp-content/uploads/2019/11/384_2012_kn_ag.pdf
4. https://doi.org/10.1016/B978-0-444-53717-1.01466-9
5. https://www.pfizermedicalinformation.com/enus/aldactone/clinical-pharmacology6. Verhamme K., Mosis G., Dieleman J., Stricker B., Sturkenboom M. Spironolactone and risk of upper gastroinsestinal events: populatione-based case-control study. BMJ 2006; 333(7566): 501.
7. Jodi Heshka, MDa, Marcel Ruzicka, MD, PhDa,b,c, Swapnil Hiremath, MD, MPHa,b,c, and Brendan B. McCormick, MD. Journal of American Society of Hypertension 4(6) (2010) 295-301.
8. Susan M. Garthwaite, Ellen G. Mcmahon. The evolution of aldosterone antagonists. Molecular and Cellular Endocrinology 217 (2004) 27–31.
9. Aldactone (Spironolactone). U.S. Food and Drug Administration (FDA).
10. Inspra (Eplerenone). U.S. Food and Drug Administration (FDA).
11. Furman B.L. Eplerenone. Strathclyde Institute of Pharmacy and Biomedical Sciences, Glasgow, United Kingdom. Elsevier. (2017)
12. Andrew J. Stewart Coats, Louise Shewa, Eplerenone`s role in the management of complex cardiovascular disorders, International Journal of Cardiology, 2015.
13. James AS Muldowney III, John A Schoenhard & Cassandra D Benge. The clinical pharmacology of eplerenone. Expert Opin. Drug Metab. Toxicol. (2009) 5(4):425-432.
14. https://www.pfizermedicalinformation.com/enus/eplerenone/clinical-pharmacology
15. Bertram Pitt, M.D., Willem Remme, M.D., Faiez Zannad, M.D., James Neaton, Ph.D., Felipe Martinez, M.D., Barbara Roniker, M.D., Richard Bittman, Ph.D., Steve Hurley, B.S., Jay Kleiman, M.D., and Marjorie Gatlin, M.D. Eplerenone, a Selective Aldosterone Blocker, in Patients with Left Ventricular Dysfunction after Myocardial Infarction. The new england journal of medicine. 2003
16. Faiez Zannad, M.D., Ph.D., John J.V. McMurray, M.D., Henry Krum, M.B., Ph.D., Dirk J. van Veldhuisen, M.D., Ph.D., Karl Swedberg, M.D., Ph.D., Harry Shi, M.S., John Vincent, M.B., Ph.D., Stuart J. Pocock, Ph.D., and Bertram Pitt, M.D., for the EMPHASISHF Study Group. Eplerenone in Patients with Systolic Heart Failure and Mild Symptoms. The new england journal of medicine. 2011
17. Tam TSC, Wu MHY, Masson SC, Tsang MP, Stabler SN, Kinkade A, Tung A, Tejani AM. Eplerenone for hypertension. Cochrane Database of Systematic Reviews 2017, Issue 2. Art. No.: CD008996.
18. Francesco Pelliccia, Giuseppe Patti, Giuseppe Rosano, Cesare Greco, Carlo Gaudio. Efficacy and safety of eplerenone in the management of mild to moderate arterial hypertension: Systematic review and metaanalysis. International Journal of Cardiology 177, 219-228. 2014
19. Подзолков В.И., Драгомирецкая Н.А. Антагонисты альдостерона. Современные представления о механизмах действия и эффектах спиронолактона. Рациональная Фармакотерапия в Кардиологии 2017; 13 (2): 263-269. DOI: http://dx.doi.org/10.20996/1819-6446-2017-13-2-263-269
20. Thomas Unger, Claudio Borghi, Fadi Charchar, Nadia A. Khan, Neil R. Poulter, Dorairaj Prabhakaran, Agustin Ramirez, Markus Schlaich, George S. Stergiou, Maciej Tomaszewski, Richard D. Wainford, Bryan Williams, Aletta E. Schutte 2020 International Society of Hypertension Global Hypertension Practice Guidelines DOI: 10.1161/HYPERTENSIONAHA.120.15026
21. Bertram Pitt, M.D., Faiez Zannad, M.D., Willem J. Remme, M.D., Robert Cody, M.D., Alain Castaigne, M.D., Alfonso Perez, M.D., Jolie Palensky, M.S., And Janet Wittes, Ph.D. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. The New England Journal of Medicine. September 2, 1999
22. Chunbin Wang, MD, Bo Xiong, MD, Jing Huang, MD. Efficacy and Safety of Spironolactone in Patients with Resistant Hypertension: A Metaanalysis of Randomised Controlled Trials. Heart, Lung and Circulation (2016) xx, 1–10. http://dx.doi.org/10.1016/j.hlc.2016.02.016
23. Bryan Williams, Thomas M MacDonald, Steve Morant, David J Webb, Peter Sever, Gordon McInnes, Ian Ford, J Kennedy Cruickshank, Mark J Caulfi eld, Jackie Salsbury, Isla Mackenzie, Sandosh Padmanabhan, Morris J Brown, for The British Hypertension Society’s PATHWAY Studies Group. 2015
24. Verena Fourkiotis, Oliver Vonend, Sven Diederich, Evelyn Fischer, Katharina Lang, Stephan Endres, Felix Beuschlein, Holger S Willenberg, Lars C Rump, Bruno Allolio, Martin Reincke, Marcus Quinkler and for the Mephisto Study Group. Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism. European Journal of Endocrinology (2013) 168 75–81. DOI: 10.1530/EJE-12-0631
25. Hitoshi Minakuchi, ShuWakino, Hidenori Urai, Arata Kurokochi, Kazuhiro Hasegawa, Takeshi Kanda, HirobumiTokuyama & Hiroshi Itoh. The efect of aldosterone and aldosterone blockade on the progression of chronic kidney disease: a randomized placebo‑controlled clinical trial. Natureresearch. Scientific reports.(2020) 10:16626 https://doi.org/10.1038/s41598-020-73638-4
26. Murray Epstein,Gordon H. Williams, Myron Weinberger, Andrew Lewin, Scott Krause, Robin Mukherjee, Rajiv Patni, and Bruce Beckerman. Selective Aldosterone Blockade with Eplerenone Reduces Albuminuria in Patients with Type 2 Diabetes. 2006 by the American Society of Nephrology. ISSN: 1555-
9041/105-0940
27. Romain Eschalier, M.D. John J.V. McMurray, M.D. Karl Swedberg, M.D., Ph.D. Dirk J. van Veldhuisen, M.D., Ph.D. Henry Krum, M.B., Ph.D. Stuart J. Pocock, Ph.D. Harry Shi, M.S. John Vincent, M.B., Ph.D. Patrick Rossignol, M.D., Ph.D. Faiez Zannad, M.D., Ph.D. Bertram Pitt, M.D. Safety and efficacy of eplerenone in patients at high-risk for hyperkalemia and/or worsening renal function: Analyses of EMPHASIS-HF study subgroups. Journal of the American College of Cardiology. 2013. DOI: 10.1016/j.jacc.2013.04.086
28. Stefan Brunner, MD Sabina P.W. Guenther, MD Korbinian Lackermair, MD Sven Peterss, MD Martin Orban, MD Anne-Laure Boulesteix, PhD Sebastian Michel, MD Jörg Hausleiter, MD *Steffen Massberg, MD Christian Hagl, MD. Estimated Long-Term Survival With Eplerenone. 2019. https://doi.org/10.1016/
j.jacc.2019.02.043
29. Andrew S. Bomback. Mineralocorticoid Receptor Antagonists in End-Stage Renal Disease: Efficacy and Safety. Karger. Review – Advances in CKD 2016. DOI:10.1159/000441262
30. Matthew J. Volk & Andrew S. Bomback & Philip J. Klemmer. Mineralocorticoid Receptor Blockade in Chronic Kidney Disease. Springer Science+Business Media, LLC 2011. DOI 10.1007/s11906-011-0202-2
31. Wenguang Feng, Louis J Dell’Italia, Paul W Sanders. Novel Paradigms of Salt and Hypertension. J Am Soc Nephrol. 2017. DOI:10.1681/ASN.2016080927
32. Міщенко Л.А., Матова О.О., Шеремет М.Ю., Сербенюк К.І. Порівняльна ефективність спіронолактону, еплеренону, небівололу і моксонідину у хворих на резистентну артеріальну гіпертензію. Український кардіологічний журнал 6/2018. DOI: http://doi.org/10.31928/1608-635X-2018.6.6571
33. Застосування діуретиків у пацієнтів із артеріальною гіпертензією: перспективий обмеження. Матюха Лариса Федорівна. Український медичний часопис. УДК 616.12-008.331.1+616-08-035+612.464.1 https://www.umj.com.ua/wp/wp-content/uploads/2016/04/3088.pdf?upload=
34. Lawrence R. Krakoff. Diuretics for Hypertension. Circulation. https://doi.org/10.1161/ CIRCULATIONAHA.105.570192
35. MICROZIDE (Hydrochlorothiazide). U.S. Food & Drug Administration (FDA) https:// www.accessdata.fda.gov/drugsatfda_docs/label/2011/020504s018lbl.pdf

Published

2021-12-14

How to Cite

Moyseyenko В., Bondur В., & Lyubitsky А. (2021). CLINICAL AND PHARMACOLOGICAL FEATURES OF THE USE OF ALDOSTERONE ANTAGONISTS IN PATIENTS WITH HYPERTONIC DISEASE. Actual Problems of Nephrology, (29), 42–50. https://doi.org/10.37321/nefrology.2021.29-04

Most read articles by the same author(s)

1 2 > >>