Spironolakton – czy wciąż jest przydatny w praktyce klinicznej? Artykuł przeglądowy
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Opublikowane:
gru 31, 2015
Słowa kluczowe:
spironolakton, aldosteron, eplerenon, antagoniści receptora mineralokortykoidowego, nadciśnienie tętnicze, niewydolność serca, pierwotny hiperaldosteronizm
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Abstrakt
Leki z grupy antagonistów receptora mineralokortykoidowego są często stosowane u osób z chorobami układu krążenia. Między dwoma dostępnymi lekami z tej grupy występują pewne istotne różnice. Spironolakton działa silniej i dłużej, ale z uwagi na efekty niepożądane zależne od jego działania antyandrogennego oraz progestagennego może być gorzej tolerowany przez niektórych pacjentów. Oba leki są skuteczne w leczeniu nadciśnienia tętniczego, pierwotnego hiperaldosteronizmu i niewydolności serca, ale porównanie ich wartości klinicznej jest utrudnione ze względu na brak dużych bezpośrednich badań porównawczych z oceną klinicznych wyników leczenia. W niniejszej pracy podsumowano dostępne dane na temat wartości spironolaktonu w leczeniu pacjentów z chorobami układu krążenia, ze szczególnym uwzględnieniem danych pozwalających porównać spironolakton z eplerenonem, aby ułatwić klinicystom dokonywanie wyboru między dostępnymi lekami z grupy antagonistów receptora mineralokortykoidowego.
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Jak cytować
Jędrusik , P. (2015). Spironolakton – czy wciąż jest przydatny w praktyce klinicznej? . Medycyna Faktów , 8(4(29), 33-44. Pobrano z https://journalsmededu.pl/index.php/jebm/article/view/2280
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Bibliografia
1. Nagarajan V., Chamsi-Pasha M., Tang W.H.W.: The role of aldosterone receptor antagonists in the management of heart failure: An update. Cleve. Clin. J. Med. 2012; 79: 631-639.
2. Struthers A., Krum H., Williams G.H.: A comparison of the aldosterone-blocking agents eplerenone and spironolactone. Clin. Cardiol. 2008; 31: 153-158.
3. Maron B.A., Leopold J.A.: Aldosterone antagonists: effective but often forgotten. Circulation 2010; 121: 934-939.
4. Tykarski A., Narkiewicz K., Gaciong Z. et al.: Zasady postępowania w nadciśnieniu tętniczym – 2015 rok. Wytyczne Polskiego Towarzystwa Nadciśnienia Tętniczego. Nadciśnienie Tętnicze 2015 (w druku).
5. Batterink J., Stabler S.N., Tejani A.M., Fowkes C.T.: Spironolactone for hypertension. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD008169 [doi: 10.1002/14651858.CD008169.pub2].
6. Jeunemaitre X., Chatellier G., Kreft-Jais C. et al.: Efficacy and tolerance of spironolactone in essential hypertension. Am. J. Cardiol. 1987; 60: 820-825.
7. Nishizaka M.K., Zaman M.A., Calhoun D.A.: Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am. J. Hypertens. 2003; 16: 925-930.
8. Adlin E.V., Marks A.D., Channick B.J.: Spironolactone and hydrochlorothiazide in essential hypertension. Arch. Intern. Med. 1972; 130: 855-858.
9. Kreeft J.H., Larochelle P., Ogilive R.I.: Comparison of chlorthalidone and spironolactone in low-renin essential hypertension. Can. Med. Assoc. J. 1983; 128: 31-34.
10. Karlberg B.E., Kagedal B., Tegler L. et al.: Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity. Am. J. Cardiol. 1976; 37: 642-649.
11. Henry M., Wehrlen M., Pelletier B. et al.: Spironolactone versus nifedipine in essential hypertension. Am. J. Cardiol. 1990; 65: 36K-38K.
12. Plouin P.F., Battaglia C., Alhenc-Gélas F. et al.: Are angiotensin converting enzyme inhibition and aldosterone antagonism equivalent in hypertensive patients over fifty? Am. J. Hypertens. 1991; 4: 356-362.
13. Weinberger M.H., Roniker B., Krause S.L. et al.: Eplerenone, a selective aldosterone blocker, in mild-to-moderate hypertension. Am. J. Hypertens. 2002; 15: 709-716.
14. Catena C., Colussi G.L., Lapenna R. et al.: Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918.
15. Gaddam K., Corros C., Pimenta E. et al.: Rapid reversal of left ventricular hypertrophy and intracardiac volume overload in patients with resistant hypertension and hyperaldosteronism: a prospective clinical study. Hypertension 2010; 55: 1137-1142.
16. Sato A., Suzuki Y., Saruta T.: Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. Hypertens. Res. 1999; 22: 17-22.
17. Taniguchi I., Kawai M., Date T. et al.: Effects of spironolactone during an angiotensin II receptor blocker treatment on the left ventricular mass reduction in hypertensive patients with concentric left ventricular hypertrophy. Circ. J. 2006; 70: 995-1000.
18. Chapman N., Dobson J., Wilson S. et al.: Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension 2007; 49: 1-7.
19. Vaclavik J., Sedlak R., Plachy M. et al.: Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension 2011; 57: 1069-1075.
20. Rodilla E., Costa J.A., Perez-Lahiguera F. et al.: Spironolactone and doxazosin treatment in patients with resistant hypertension. Rev. Esp. Cardiol. 2009; 62: 158-166.
21. Viera A.J.: Resistant hypertension. J. Am. Board Fam. Med. 2012; 25: 487-495.
22. Parthasarathy K.H., Menard J., White W.B.: A double-blind, randomized study comparing the antihypertensive effect of eplerenone and spironolactone in patients with hypertension and evidence of primary aldosteronism. J. Hypertens. 2011; 29: 980-990.
23. Karagiannis A., Tziomalos K., Papageorgiou A. et al.: Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin. Pharmacother. 2008; 9: 509-515.
24. Fourkiotis V., Vonend O., Diederich S. et al.: Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism. Eur. J. Endocrinol. 2013; 168: 75-81.
25. Pitt B., Zannad F., Remme W.J. et al.: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N. Engl. J. Med. 1999; 341: 709-717.
26. Hamaguchi S., Kinugawa S., Tsuchihashi-Makaya M. et al.: Spironolactone use at discharge was associated with improved survival in hospitalized patients with systolic heart failure. Am. Heart J. 2010; 160: 1156-1162.
27. Vizzardi E., Nodari S., Caretta G. et al.: Effects of spironolactone on long-term mortality and morbidity in patients with heart failure and mild or no symptoms. Am. J. Med. Sci. 2014; 347: 271-276.
28. Hayashi M., Tsutamoto T., Wada A. et al.: Immediate administration of mineralocorticoid receptor antagonist spironolactone prevents postinfarct left ventricular remodeling associated with suppression of a marker of myocardial collagen synthesis in patients with first anterior acute myocardial infarction. Circulation 2003; 107: 2559-2565.
29. Pitt B., Remme W., Zannad F. et al.: Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N. Engl. J. Med. 2003; 348: 1309-1321.
30. Zannad F., McMurray J.J.V., Krum H. et al.: Eplerenone in patients with systolic heart failure and mild symptoms. N. Engl. J. Med. 2011; 364: 11-21.
31. McMurray J.J.V., Adamopoulos S., Anker S.D. et al.: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur. Heart J. 2012; 33: 1787-1847.
32. Yancy C.W., Jessup M., Bozkurt B. et al.: 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 128: e240-e327.
33. Chatterjee S., Moeller C., Shah N. et al.: Eplerenone is not superior to older and less expensive aldosterone antagonists. Am. J. Med. 2012; 125: 817-825.
34. Yamaji M., Tsutamoto T., Kawahara C. et al.: Effect of eplerenone versus spironolactone on cortisol and hemoglobin A1c levels in patients with chronic heart failure. Am. Heart J. 2010; 160: 915-921.
35. Roongsritong C., Sutthiwan P., Bradley J. et al.: Spironolactone improves diastolic function in the elderly. Clin. Cardiol. 2005; 28: 484-487.
36. Sato A., Hayashi M., Saruta T.: Relative long-term effects of spironolactone in conjunction with angiotensin-converting enzyme inhibitors on left ventricular mass and diastolic function in patients with essential hypertension. Hypertens. Res. 2002; 25: 837-842.
37. Gupta A., Schiros C.G., Gaddam K.K. et al.: Effect of spironolactone on diastolic function in hypertensive left ventricular hypertrophy. J. Hum. Hypertens. 2015; 29: 241-246.
38. Edelmann F., Wachter R., Schmidt A.G. et al.: Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA 2013; 309: 781-791.
39. Pitt B., Pfeffer M.A., Assmann S.F. et al.: Spironolactone for heart failure with preserved ejection fraction. N. Engl. J. Med. 2014; 370: 1383-1392.
40. Pfeffer M.A., Claggett B., Assmann S.F.et al.: Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation 2015; 131: 34-42.
41. Zile M.R., Gaasch W.H.: UpToDate: Treatment and prognosis of diastolic heart failure, 2014.
42. Williams R.S., deLemos J.A., Dimas V. et al.: Effect of spironolactone on patients with atrial fibrillation and structural heart disease. Clin. Cardiol. 2011; 34: 415-419.
43. Gaddam K., Pimenta E., Thomas S.J. et al.: Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J. Hum. Hypertens. 2010; 24: 532-537.
44. Bianchi S., Bigazzi R., Campese V.M.: Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int. 2006; 70: 2116-2123.
45. Navaneethan S.D., Nigwekar S.U., Sehgal A.R. et al.: Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 2009; 4: 542-551.
46. Schjoedt K.J., Rossing K., Juhl T.R. et al.: Beneficial impact of spironolactone on nephrotic range albuminuria in diabetic nephropathy. Kidney Int. 2006; 70: 536-542.
47. Oxlund C., Henriksen J., Tarnow L. et al.: Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomised clinical trial. J. Hypertens. 2013; 31: 2094-2102.
48. Bomback A.S., Muskala P., Bald E. et al:. Low-dose spironolactone, added to long-term ACE inhibitor therapy, reduces blood pressure and urinary albumin excretion in obese patients with hypertensive target organ damage. Clin. Nephrol. 2009; 72: 449-456.
49. Unger T., Paulis L., Sica D.A.: Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches. Eur. Heart J. 2011; 32: 2739-2747.
2. Struthers A., Krum H., Williams G.H.: A comparison of the aldosterone-blocking agents eplerenone and spironolactone. Clin. Cardiol. 2008; 31: 153-158.
3. Maron B.A., Leopold J.A.: Aldosterone antagonists: effective but often forgotten. Circulation 2010; 121: 934-939.
4. Tykarski A., Narkiewicz K., Gaciong Z. et al.: Zasady postępowania w nadciśnieniu tętniczym – 2015 rok. Wytyczne Polskiego Towarzystwa Nadciśnienia Tętniczego. Nadciśnienie Tętnicze 2015 (w druku).
5. Batterink J., Stabler S.N., Tejani A.M., Fowkes C.T.: Spironolactone for hypertension. Cochrane Database of Systematic Reviews 2010, Issue 8. Art. No.: CD008169 [doi: 10.1002/14651858.CD008169.pub2].
6. Jeunemaitre X., Chatellier G., Kreft-Jais C. et al.: Efficacy and tolerance of spironolactone in essential hypertension. Am. J. Cardiol. 1987; 60: 820-825.
7. Nishizaka M.K., Zaman M.A., Calhoun D.A.: Efficacy of low-dose spironolactone in subjects with resistant hypertension. Am. J. Hypertens. 2003; 16: 925-930.
8. Adlin E.V., Marks A.D., Channick B.J.: Spironolactone and hydrochlorothiazide in essential hypertension. Arch. Intern. Med. 1972; 130: 855-858.
9. Kreeft J.H., Larochelle P., Ogilive R.I.: Comparison of chlorthalidone and spironolactone in low-renin essential hypertension. Can. Med. Assoc. J. 1983; 128: 31-34.
10. Karlberg B.E., Kagedal B., Tegler L. et al.: Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity. Am. J. Cardiol. 1976; 37: 642-649.
11. Henry M., Wehrlen M., Pelletier B. et al.: Spironolactone versus nifedipine in essential hypertension. Am. J. Cardiol. 1990; 65: 36K-38K.
12. Plouin P.F., Battaglia C., Alhenc-Gélas F. et al.: Are angiotensin converting enzyme inhibition and aldosterone antagonism equivalent in hypertensive patients over fifty? Am. J. Hypertens. 1991; 4: 356-362.
13. Weinberger M.H., Roniker B., Krause S.L. et al.: Eplerenone, a selective aldosterone blocker, in mild-to-moderate hypertension. Am. J. Hypertens. 2002; 15: 709-716.
14. Catena C., Colussi G.L., Lapenna R. et al.: Long-term cardiac effects of adrenalectomy or mineralocorticoid antagonists in patients with primary aldosteronism. Hypertension 2007; 50: 911-918.
15. Gaddam K., Corros C., Pimenta E. et al.: Rapid reversal of left ventricular hypertrophy and intracardiac volume overload in patients with resistant hypertension and hyperaldosteronism: a prospective clinical study. Hypertension 2010; 55: 1137-1142.
16. Sato A., Suzuki Y., Saruta T.: Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. Hypertens. Res. 1999; 22: 17-22.
17. Taniguchi I., Kawai M., Date T. et al.: Effects of spironolactone during an angiotensin II receptor blocker treatment on the left ventricular mass reduction in hypertensive patients with concentric left ventricular hypertrophy. Circ. J. 2006; 70: 995-1000.
18. Chapman N., Dobson J., Wilson S. et al.: Effect of spironolactone on blood pressure in subjects with resistant hypertension. Hypertension 2007; 49: 1-7.
19. Vaclavik J., Sedlak R., Plachy M. et al.: Addition of spironolactone in patients with resistant arterial hypertension (ASPIRANT): a randomized, double-blind, placebo-controlled trial. Hypertension 2011; 57: 1069-1075.
20. Rodilla E., Costa J.A., Perez-Lahiguera F. et al.: Spironolactone and doxazosin treatment in patients with resistant hypertension. Rev. Esp. Cardiol. 2009; 62: 158-166.
21. Viera A.J.: Resistant hypertension. J. Am. Board Fam. Med. 2012; 25: 487-495.
22. Parthasarathy K.H., Menard J., White W.B.: A double-blind, randomized study comparing the antihypertensive effect of eplerenone and spironolactone in patients with hypertension and evidence of primary aldosteronism. J. Hypertens. 2011; 29: 980-990.
23. Karagiannis A., Tziomalos K., Papageorgiou A. et al.: Spironolactone versus eplerenone for the treatment of idiopathic hyperaldosteronism. Expert Opin. Pharmacother. 2008; 9: 509-515.
24. Fourkiotis V., Vonend O., Diederich S. et al.: Effectiveness of eplerenone or spironolactone treatment in preserving renal function in primary aldosteronism. Eur. J. Endocrinol. 2013; 168: 75-81.
25. Pitt B., Zannad F., Remme W.J. et al.: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. N. Engl. J. Med. 1999; 341: 709-717.
26. Hamaguchi S., Kinugawa S., Tsuchihashi-Makaya M. et al.: Spironolactone use at discharge was associated with improved survival in hospitalized patients with systolic heart failure. Am. Heart J. 2010; 160: 1156-1162.
27. Vizzardi E., Nodari S., Caretta G. et al.: Effects of spironolactone on long-term mortality and morbidity in patients with heart failure and mild or no symptoms. Am. J. Med. Sci. 2014; 347: 271-276.
28. Hayashi M., Tsutamoto T., Wada A. et al.: Immediate administration of mineralocorticoid receptor antagonist spironolactone prevents postinfarct left ventricular remodeling associated with suppression of a marker of myocardial collagen synthesis in patients with first anterior acute myocardial infarction. Circulation 2003; 107: 2559-2565.
29. Pitt B., Remme W., Zannad F. et al.: Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N. Engl. J. Med. 2003; 348: 1309-1321.
30. Zannad F., McMurray J.J.V., Krum H. et al.: Eplerenone in patients with systolic heart failure and mild symptoms. N. Engl. J. Med. 2011; 364: 11-21.
31. McMurray J.J.V., Adamopoulos S., Anker S.D. et al.: ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. Eur. Heart J. 2012; 33: 1787-1847.
32. Yancy C.W., Jessup M., Bozkurt B. et al.: 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2013; 128: e240-e327.
33. Chatterjee S., Moeller C., Shah N. et al.: Eplerenone is not superior to older and less expensive aldosterone antagonists. Am. J. Med. 2012; 125: 817-825.
34. Yamaji M., Tsutamoto T., Kawahara C. et al.: Effect of eplerenone versus spironolactone on cortisol and hemoglobin A1c levels in patients with chronic heart failure. Am. Heart J. 2010; 160: 915-921.
35. Roongsritong C., Sutthiwan P., Bradley J. et al.: Spironolactone improves diastolic function in the elderly. Clin. Cardiol. 2005; 28: 484-487.
36. Sato A., Hayashi M., Saruta T.: Relative long-term effects of spironolactone in conjunction with angiotensin-converting enzyme inhibitors on left ventricular mass and diastolic function in patients with essential hypertension. Hypertens. Res. 2002; 25: 837-842.
37. Gupta A., Schiros C.G., Gaddam K.K. et al.: Effect of spironolactone on diastolic function in hypertensive left ventricular hypertrophy. J. Hum. Hypertens. 2015; 29: 241-246.
38. Edelmann F., Wachter R., Schmidt A.G. et al.: Effect of spironolactone on diastolic function and exercise capacity in patients with heart failure with preserved ejection fraction: the Aldo-DHF randomized controlled trial. JAMA 2013; 309: 781-791.
39. Pitt B., Pfeffer M.A., Assmann S.F. et al.: Spironolactone for heart failure with preserved ejection fraction. N. Engl. J. Med. 2014; 370: 1383-1392.
40. Pfeffer M.A., Claggett B., Assmann S.F.et al.: Regional variation in patients and outcomes in the Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist (TOPCAT) trial. Circulation 2015; 131: 34-42.
41. Zile M.R., Gaasch W.H.: UpToDate: Treatment and prognosis of diastolic heart failure, 2014.
42. Williams R.S., deLemos J.A., Dimas V. et al.: Effect of spironolactone on patients with atrial fibrillation and structural heart disease. Clin. Cardiol. 2011; 34: 415-419.
43. Gaddam K., Pimenta E., Thomas S.J. et al.: Spironolactone reduces severity of obstructive sleep apnoea in patients with resistant hypertension: a preliminary report. J. Hum. Hypertens. 2010; 24: 532-537.
44. Bianchi S., Bigazzi R., Campese V.M.: Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease. Kidney Int. 2006; 70: 2116-2123.
45. Navaneethan S.D., Nigwekar S.U., Sehgal A.R. et al.: Aldosterone antagonists for preventing the progression of chronic kidney disease: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 2009; 4: 542-551.
46. Schjoedt K.J., Rossing K., Juhl T.R. et al.: Beneficial impact of spironolactone on nephrotic range albuminuria in diabetic nephropathy. Kidney Int. 2006; 70: 536-542.
47. Oxlund C., Henriksen J., Tarnow L. et al.: Low dose spironolactone reduces blood pressure in patients with resistant hypertension and type 2 diabetes mellitus: a double blind randomised clinical trial. J. Hypertens. 2013; 31: 2094-2102.
48. Bomback A.S., Muskala P., Bald E. et al:. Low-dose spironolactone, added to long-term ACE inhibitor therapy, reduces blood pressure and urinary albumin excretion in obese patients with hypertensive target organ damage. Clin. Nephrol. 2009; 72: 449-456.
49. Unger T., Paulis L., Sica D.A.: Therapeutic perspectives in hypertension: novel means for renin-angiotensin-aldosterone system modulation and emerging device-based approaches. Eur. Heart J. 2011; 32: 2739-2747.