spironolactone / Generic mfg. - LARVOL DELTA

Cardioprotection without risk? meta-analysis of prophylactic agents in low-risk cancer patients on anthracyclines (ASH 2025) - "We included randomized controlled trials (RCTs) of prophylactic ACE inhibitors, ARBs, beta-blockers, statins, dexrazoxane, or SGLT2 inhibitors in adults without pre-existing cardiovascular risk factors...Agents studied included beta-blockers (nebivolol, carvedilol, bisoprolol), ACE inhibitors (ramipril), ARBs (telmisartan), and spironolactone. Treatment duration ranged from 4 months to 1 year; anthracycline doses reached up to 689 mg/m² (epirubicin) or 536 mg/m² (doxorubicin)...The protective benefit was greater in contexts involving higher cumulative anthracycline doses and concurrent cardiotoxic therapies such as trastuzumab...However, high heterogeneity limits firm conclusions. Given the moderate effect size and heterogeneity, further large-scale, well-formulated trials are essential to identify optimal cardioprotective agents and precise patient selection criteria."

Retrospective data • Breast Cancer • Congestive Heart Failure • Heart Failure • Oncology • Solid Tumor

A rare case of gelatinous transformation of the bone marrow secondary to untreated hypothyroidism and congestive heart failure (ASH 2025) - "He was empirically treated with cefepime and azithromycin for presumed sepsis...He was started on levothyroxine 25 mcg, Jardiance 10 mg, and spironolactone 25 mg for HFpEF...Diagnosing GTBM requires a high index of suspicion and exclusion of other pancytopenia causes. Early recognition and treatment of the underlying disorder can reverse both GTBM and associated cytopenias."

Clinical • Aplastic Anemia • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Heart Failure • Hematological Malignancies • Human Immunodeficiency Virus • Immunology • Infectious Disease • Pituitary Gland Carcinoma • Pneumonia • Pulmonary Arterial Hypertension • Pulmonary Disease • Respiratory Diseases • Septic Shock • IL2

PA14 Spironolactone for the treatment of acne vulgaris affecting female patients aged 18 years and under: results from a UK and Irish survey. (PubMed, Br J Dermatol) - "L.O. and Z.M. are first coauthors."

Journal • Acne Vulgaris • Dermatology • Hypotension • Pain • Pediatrics • Women's Health

P111 A multicentre service evaluation highlighting the variable off-label prescribing practice of spironolactone in the management of hidradenitis suppurativa: the need for evidence-based guidelines. (PubMed, Br J Dermatol) - "Most were prescribed spironolactone as an adjunct to their existing management, including oral antibiotics, metformin and adalimumab. We conclude that there is significant variability in patient selection, monitoring and prescribing practices of spironolactone for HS across these UK sites. With a view to addressing the uncertainties outlined in the James Lind Priority Setting Partnerships for HS, we propose that a multicentre randomized controlled trial is needed to inform the evidence base and to produce clear UK guidelines on treatment with spironolactone in HS."

Journal • Retrospective data • Dermatology • Hidradenitis Suppurativa • Immunology • Inflammation • Pain • Xerostomia

Permanent pacemaker implantation with high pacing rate for treating refractory right heart failure: a case report. (PubMed, Eur Heart J Case Rep) - "At the 12-month follow-up, the patient was classified as New York Heart Association Class I and did not experience recurrence of oedema, even while taking low-dose diuretics (torasemide, 5 mg once daily, and spironolactone, 20 mg once daily). In addition, patients who undergo Fontan surgery can remain asymptomatic for decades, suggesting that left ventricular pump function may be sufficient to sustain both systemic and pulmonary circulation. Therefore, increasing HR can increase cardiac output, promote forward flow from the right atrium and vena cava into the pulmonary circulation, and reduce venous and right atrium pressures in patients with RHF and normal left-sided heart function."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Fatigue • Heart Failure

Efficacy and Safety of Hormonal Therapies for Acne: A Narrative Review. (PubMed, Clin Cosmet Investig Dermatol) - "Eligible articles included randomized controlled trials, cohort studies, systematic reviews, and meta-analyses evaluating hormonal therapies such as combined oral contraceptives (COCs), spironolactone, cyproterone acetate, and topical antiandrogens (eg, clascoterone)...Hormonal therapies are effective and well-tolerated options for acne, particularly in women with hormonal patterns or refractory disease. By specifically targeting androgen-driven pathways, hormonal agents offer sustained improvement and should be incorporated into personalized acne management."

Journal • Review • Acne Vulgaris • Dermatology • Inflammation

BH20 A multicentre analysis of the adequacy of alopecia horizontal biopsy samples over 10 years. (PubMed, Br J Dermatol) - "Twenty-six patients had received either topical steroids, minoxidil, spironolactone, tamoxifen, contraceptive pill, azathioprine or ketoconazole shampoo. We recommend using a standardized alopecia request form with clinical data and duration of onset, avoiding biopsies for very early or very late-onset disease of > 4 years, and inserting a follicular analysis table within the report to compare with the normal standard values, to improve the diagnostic outcome. Combining the use of digital pathology with artificial intelligence in the future may increase the diagnostic accuracy."

Journal • Retrospective data • Acne Vulgaris • Alopecia • Atopic Dermatitis • Breast Cancer • Chronic Kidney Disease • CNS Disorders • Crohn's disease • Depression • Dermatology • Dermatomyositis • Dermatopathology • Diabetes • Endocrine Disorders • Gastroenterology • Genetic Disorders • Immunology • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Metabolic Disorders • Mood Disorders • Multiple Sclerosis • Myositis • Oncology • Polycystic Ovary Syndrome • Psoriasis • Psychiatry • Renal Disease • Rheumatology • Sjogren's Syndrome • Solid Tumor • Systemic Lupus Erythematosus • Urticaria

BH04 Growing interest: a survey of low-dose oral minoxidil prescribing for hair loss. (PubMed, Br J Dermatol) - "For female pattern hair loss, 90% (n = 26) would prescribe LDOM as monotherapy and 66% (n = 19) would use it with spironolactone. For FFP/LPP, 79% (n = 23) would not prescribe LDOM as monotherapy, but would use it as an adjunct, most commonly with hydroxychloroquine (n = 20), followed by tetracyclines (n = 19)...Our study highlights the variation in LDOM prescribing within the UK and Ireland. It demonstrates the wide use of LDOM by dermatologists both as an adjunct and as monotherapy for a wide range of hair loss conditions."

Journal • Alopecia • Fibrosis • Immunology • Lichen Planus

Selective and nonselective mineralocorticoid receptor antagonists in central serous chorioretinopathy: systematic review and meta-analysis. (PubMed, BMC Ophthalmol) - No abstract available

Journal • Retrospective data • Review • Retinal Disorders

Pharmacological prevention in cardio-oncology: from bench-to-bedside. (PubMed, Heart Fail Rev) - "Neurohormonal blockers, including ACE inhibitors, ARBs, and β-blockers, constitute the foundation of prevention, although their efficacy varies: combinations such as ACEi/ARB with βB yield mixed outcomes, whereas carvedilol offers antioxidant benefits beyond β-blockade. Sacubitril/valsartan (ARNI) has demonstrated improvements in global longitudinal strain and LVEF preservation in the SARAH trial, albeit with associated hypotension risks. Aldosterone antagonists show potential, with spironolactone preserving LVEF and diastolic function, though eplerenone has not shown significant effects. Statins present conflicting data; the STOP-CA trial supports atorvastatin for LVEF preservation, while the PREVENT and SPARE-HF trials found no benefit. Emerging evidence suggests sodium-glucose cotransporter-2 inhibitors (SGLT2i), such as dapagliflozin and empagliflozin, as promising agents, with preclinical and early clinical data indicating cardioprotection through metabolic..."

Journal • Review • Cardiovascular • Hypotension • Metabolic Disorders • Oncology • ICOS

Amiloride: revisiting an old drug for resistant hypertension. (PubMed, Clin Hypertens) - "The findings from the SPARE trial suggest that amiloride may be a viable alternative to spironolactone for RH, particularly in patients who are intolerant to mineralocorticoid receptor antagonists. While spironolactone remains the preferred option due to its established role in blocking systemic aldosterone activation and proven cardiovascular benefits, amiloride can provide a practical and well-tolerated alternative."

Journal • Review • Cardiovascular • Fibrosis • Hypertension • Immunology • Women's Health

Unmasking Secondary Hypertension: Renal Artery Stenosis Concealing the Diagnosis of Primary Hyperaldosteronism. (PubMed, Cureus) - "Persistently suppressed renin and unexplained hypokalemia in the setting of uncontrolled hypertension, even after renal revascularization, should prompt clinicians to revisit the possibility of primary aldosteronism. This case underscores the importance of avoiding premature closure, maintaining vigilance for multiple etiologies, and reassessing the differential diagnosis when treatment of a plausible condition does not yield the expected clinical improvement."

Journal • Cardiovascular • Cushing’s Disease • Endocrine Disorders • Hypertension • Metabolic Disorders • Nephrology • Oncology • Pain • Solid Tumor

High-Throughput Screening Using the Self-Controlled Tree-Based Scan Statistic to Identify Medications Associated With Hospitalization for Severe Acute Liver Injury. (PubMed, Pharmacoepidemiol Drug Saf) - "High-throughput screening using tree-based scan statistics detected potentially hepatotoxic drugs for investigation in future pharmacoepidemiology studies."

Journal • CNS Disorders • Gastroenterology • Hepatology • Liver Failure • Pain

Spironolactone in end stage renal disease: A story of under'ACHIEVE'ment. (PubMed, J Bras Nefrol) - No abstract available

Journal • Chronic Kidney Disease • Nephrology • Renal Disease

Isatuximab for Refractory Primary FSGS (KIDNEY WEEK 2025) - "He achieved partial remission with steroids, tacrolimus, and mycophenolate mofetil (MMF), and eventually stabilized on prednisone and tacrolimus, with losartan, empagliflozin, spironolactone, and atorvastatin...After rituximab induction, UPCR was 3.14, albumin 3 g/dL...CD-38 targeting antibodies such as isatuximab have been studied in the treatment of immune-mediated diseases, including primary FSGS, demonstrating either total remission or improvement in disease severity in cases refractory to conventional therapies. Further research is needed to determine optimal treatment regimens and dosing frequency, better study their efficacy, and the potential risk of adverse effects."

Chronic Kidney Disease • Focal Segmental Glomerulosclerosis • Gastrointestinal Cancer • Gastrointestinal Stromal Tumor • Glomerulonephritis • Immunology • Nephrology • Renal Disease • Sarcoma

Targeting DNA repair mechanisms with spironolactone to enhance LP-184 CNS pharmacodynamics and efficacy (SNO 2025) - P1/2 | "Machine learning approaches also associate spironolactone-induced GBM cell sensitization to LP-184 with down-regulation of the TC-NER complex endonuclease ERCC1 and the DNA damage sensor CETN2. These findings provide a rationale and framework for a planned Phase 1b/2a trial to evaluate LP-184 + spironolactone therapy against recurrent GBM."

Clinical • PK/PD data • Brain Cancer • Solid Tumor • Targeted Protein Degradation • ERCC1 • ERCC3

Combining spironolactone to antiretroviral therapy accelerates HIV decay in humanized mice. (PubMed, Emerg Microbes Infect) - "Additionally, SP treatment diminished markers of immune activation and inflammation, critical factors contributing to morbidity and mortality in individuals with chronic HIV infection. These results highlight SP's potential to enhance HIV treatment by mitigating key aspects of viral persistence and associated immune challenges."

Journal • Preclinical • Genetic Disorders • Human Immunodeficiency Virus • Infectious Disease • Inflammation

Targeted Therapy or Tension: A Case of Tyrosine Kinase Inhibitor-Mediated Hypertensive Crisis in a Patient with Advanced Renal Cell Carcinoma (KIDNEY WEEK 2025) - "Case Description A 71-year-old woman with well-controlled hypertension on lisinopril 20 mg daily and prior RCC treated by radical nephrectomy and short-lived pembrolizumab (stopped for immune polyarthritis) began cabozantinib 40 mg daily for progression...Twelve weeks after stopping cabozantinib, she remained markedly hypertensive despite four agents (lisinopril 40 mg qd, nifedipine 120 mg qd, chlorthalidone 25 mg qd, spironolactone 25 mg qd)...Since then, she has been receiving Belzutifan (HIF-2α inhibitor) without adverse effects. ( Ref Fig1 ) Discussion Grade 1-3 HTN was observed in about 37% of patients in the METEOR Trial (Cabozantinib versus Everolimus in Advanced Renal-Cell Carcinoma), but frank hypertensive crisis (grade 4) and true resistant hypertension are very uncommon (<1 %). Presentation with hypertensive crisis prompts discontinuation of the TKI therapy."

Clinical • Metastases • Cardiovascular • Genito-urinary Cancer • Hypertension • Immunology • Oncology • Renal Cell Carcinoma • Renal Disease • Solid Tumor • EPAS1

Finerenone Versus Spironolactone for Heart Failure with Preserved Ejection Fraction. (PubMed, Cardiovasc Drugs Ther) - "In this first direct comparison of MRAs in HFpEF, finerenone demonstrated broadly comparable effectiveness and safety to spironolactone. While these observations are hypothesis-generating, prospective studies are warranted to confirm these findings and inform therapeutic decision-making."

Journal • Acute Kidney Injury • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction • Nephrology • Renal Disease

Regulation of Klotho Production by Mineralocorticoid Receptor Signaling in Renal Cell Lines. (PubMed, Biomolecules) - "Using four renal cell lines, Madin-Darby canine kidney (MDCK), normal rat kidney, subtype 52E (NRK-52E), human kidney 2 (HK2) cells, and primary renal proximal tubule epithelial cells (RPTECs), and the four most frequently prescribed mineralocorticoid receptor blockers, spironolactone, eplerenone, finerenone, and esaxerenone, we assessed Klotho gene expression by qRT-PCR and Klotho protein by Western blotting. To conclude, common mineralocorticoid receptor antagonists are characterized by highly diverse effects on Klotho in four renal cell lines. Further studies are needed to define the role of mineralocorticoid receptor blockade for Klotho production."

Journal • Preclinical • Endocrine Disorders • Fibrosis • Heart Failure • Immunology • Inflammation • Nephrology • Renal Disease • KL

Spironolactone-Induced Gynecomastia. (PubMed, N Engl J Med) - No abstract available

Journal

Exploring Etiologies of Hypokalemic Paralysis: A Case Series. (PubMed, J Assoc Physicians India) - "This case series underscores the diverse etiologies of hypokalemic paralysis, spanning endocrine, renal, autoimmune, and genetic causes. A systematic diagnostic approach, guided by clinical and biochemical evaluation, is essential for timely treatment. Identifying the underlying cause not only ensures effective acute management but also prevents recurrence and reduces the risk of serious complications, including cardiac arrhythmias."

Journal • Cardiovascular • Endocrine Disorders • Grave’s Disease • Immunology • Metabolic Disorders • Nephrology • Sjogren's Syndrome

Cardiovascular Outcomes and Hyperkalemia Risk in Patients With Diabetes, Chronic Kidney Disease and Heart Failure: A Real-World Comparison of Non-steroidal versus Steroidal Mineralocorticoid Receptor Antagonists. (PubMed, Cureus) - " In patients with T2DM, CKD, and HF, non-steroidal MRAs were associated with improved safety and cardiovascular outcomes compared with steroidal MRAs. However, the observational study design and, hence, the limitation in data that can be collected warrant cautious interpretation. Prospective randomized head-to-head trials are warranted before adaptation in clinical practice."

Journal • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Myocardial Infarction • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Cyproterone acetate for hirsutism. (PubMed, Cochrane Database Syst Rev) - "There were some differences in clinical outcome between CPA and spironolactone, CPA and flutamide, and CPA and finasteride. There were no clinical differences between CPA and the other medical therapies, possibly because of small study size, lack of standardised assessment and objective determinants of improvement in many studies. There are insufficient data presented to compare the adverse effects of all the treatment options. Larger, carefully designed studies are needed to compare efficacy and safety profiles between the therapeutic options available."

Clinical • Journal • Review • Gynecology

Spironolactone in Alcohol Use Disorder (SAUD) (clinicaltrials.gov) - P1 | N=20 | Recruiting | Sponsor: National Institute on Drug Abuse (NIDA) | Trial completion date: Apr 2026 ➔ Apr 2027 | Trial primary completion date: Dec 2025 ➔ Dec 2026

Trial completion date • Trial primary completion date • Addiction (Opioid and Alcohol) • Congestive Heart Failure