eplerenone / Generic mfg. - LARVOL DELTA

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

Long-Term Eplerenone Treatment in Peripapillary Pachychoroid Syndrome: A Case Series. (PubMed, Case Rep Ophthalmol) - "Long-term eplerenone treatment appears effective in reducing choroidal thickness and improving visual outcomes in PPS patients. These findings suggest mineralocorticoid receptor antagonists may be valuable in managing pachychoroid spectrum disorders."

Journal • Ophthalmology

A novel mineralocorticoid receptor blocker, CS-3150, improves insulin resistance and reduces inflammation in db/db mice. (PubMed, Korean J Physiol Pharmacol) - "CS-3150 treatment reversed this effect, whereas the traditional MR antagonist eplerenone failed to do so at equivalent concentrations. In conclusion, CS-3150 improved insulin sensitivity in obese diabetic mice, likely through attenuation of adipose inflammation, reduction in fat accumulation, and enhancement of insulin signaling. These findings support the potential of CS-3150 as a therapeutic agent for obesity-associated metabolic dysfunction."

Journal • Preclinical • Genetic Disorders • Inflammation • Metabolic Disorders • Obesity • IL6 • VCAM1

Evidence-based validation of cardiovascular benefits from novel MRAs in type 2 diabetes: A meta-analysis of over 30,000 patients. (PubMed, J Diabetes Complications) - "This study provides high-certainty evidence supporting MRAs in reducing MACE and heart failure hospitalization, and moderate-certainty evidence for benefits on cardiovascular mortality. Cardioprotective effects may involve Ras, IL-17, and relaxin signaling."

Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Type 2 Diabetes Mellitus • EGFR • IL17A • MAPK10 • MMP1 • NOS2 • PACERR • PTGS2

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

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

Clinical Features and Outcomes of Bullous Central Serous Chorioretinopathy: A Multicentric Cohort Study. (PubMed, Ophthalmologica) - "The bullous variant of central serous chorioretinopathy is frequently associated with systemic conditions and has a guarded visual prognosis despite anatomical resolution in most cases. The study underscores the importance of early diagnosis and a tailored treatment to optimize outcomes in this severe CSC variant."

Journal • Fibrosis • Immunology • Retinal Disorders

CARDAMOM: Cardiac Effects of Mineralocorticoid Receptor Antagonism After Preeclampsia (clinicaltrials.gov) - P2 | N=90 | Not yet recruiting | Sponsor: Massachusetts General Hospital

New P2 trial • Cardiovascular • Gynecology • Hypertension

Early Lupus Nephritis (LN) Unmasked by Refractory Hypertension (HTN) and Pericarditis in Systemic Lupus Erythematosus (SLE) (KIDNEY WEEK 2025) - "He was diagnosed with SLE and started on corticosteroids, later transitioned to azathioprine and belimumab...He was maintained on prednisone 10 mg daily. Months later, he developed HTN refractory to amlodipine 10 mg, clonidine 0.2 mg, eplerenone 50 mg, and olmesartan 20 mg. Eplerenone was increased to 100 mg and chlorthalidone 25 mg added, but HTN persisted...In suspected proliferative LN, switching from azathioprine to mycophenolate mofetil is often favored...Timely biopsy and treatment adjustment are key to preserving renal function. Emerging therapies may support steroid-sparing approaches for glomerular and extraglomerular lupus manifestations."

Cardiovascular • Glomerulonephritis • Hypertension • Immunology • Infectious Disease • Inflammation • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Ocular Inflammation • Pulmonary Disease • Renal Disease • Respiratory Diseases • Systemic Lupus Erythematosus

Resistant Hypertension in ANCA-Associated Vasculitis: Role for Aliskiren? (KIDNEY WEEK 2025) - "Despite receiving cyclophosphamide and methylprednisolone, he remained dialysis-dependent and was referred for renal transplant. He had multiple hypertensive emergency admissions despite a multi-drug regimen with nifedipine, telmisartan, carvedilol, eplerenone, clonidine, and hydralazine, and dry weight optimization...Studies are warranted to compare DRI efficacy against standard antihypertensives in similar clinical scenarios. The views expressed in this abstract are those of the author(s) and do not necessarily reflect the official policy of the Department of Defense or the U.S. Government."

ANCA Vasculitis • Cardiovascular • Glomerulonephritis • Hypertension • Inflammation • Lupus Nephritis • Nephrology • Renal Disease • Vasculitis • MPO

Ogilvie Syndrome and Abiraterone: Untangling Two Uncommon Causes of Refractory Hypokalemia (KIDNEY WEEK 2025) - "He was started on medication regimen of Amiloride, Eplerenone, and prednisone. This results in increased sensitivity to normal serum aldosterone levels and persistent, predominantly colonic, potassium wasting. This explains this patient’s improvement on aldosterone antagonists, as it worked to suppress expression of BK channels, as well as treatment of pseudo-obstruction."

Endocrine Disorders • Genito-urinary Cancer • Hypertension • Infectious Disease • Nephrology • Prostate Cancer • Renal Disease • Septic Shock • Solid Tumor

A Storm of Cortisol: Ectopic ACTH-Induced Metabolic Chaos (KIDNEY WEEK 2025) - "Treatment was initiated with potassium chloride supplementation and eplerenone leading to improvement in the metabolic alkalosis and hypokalemia. After treatment with etoposide and carboplatin for his NET, his potassium supplements were eventually stopped...This oversaturation then activates mineralocorticoid receptors in the collecting ducts leading to sodium retention, potassium wasting, and bicarbonate reabsorption. Test results upon presentation"

Cardiovascular • Cushing’s Disease • Endocrine Disorders • Fatigue • Hypertension • Metabolic Disorders • Neuroendocrine Tumor • Prostate Adenocarcinoma • Prostate Cancer • Solid Tumor

Uncommon Presentations of Primary Aldosteronism: Edema and Hormonal Cosecretion (KIDNEY WEEK 2025) - "She chose medical therapy with eplerenone, titrated to achieve PRA >1 ng/mL/hr and normokalemia...A 1-mg dexamethasone suppression test (DST) showed abnormal cortisol (2.7 mcg/dL); 8-mg DST confirmed subclinical hypercortisolism (17.9 mcg/dL)...The second underscores evaluating cortisol co-secretion in PA with adrenal adenomas, as it affects AVS interpretation and management. Both highlight the need for diagnostic approaches beyond the classical PA phenotype."

Cardiovascular • Endocrine Disorders • Hypertension

A Balancing Act: Prostate Cancer, Antiandrogen Therapy, and Cardiovascular Disease (KIDNEY WEEK 2025) - "Case Description A 70-year-old male with no comorbidities and high risk, localized PCa was initially treated with Bicalutamide followed by radiation. Three years later due to recurrence abiraterone and prednisone was initiated...BP was refractory to five anti-HTN medications (amlodipine, hydralazine, eplerenone, clonidine, indapamide), which were added over time at tolerated doses...Mineralocorticoid receptor antagonists may interfere with Abiraterone's mechanism of action, limiting their role in treating HTN. Thus Timely recognition of PCa therapy-related side effects is essential to minimize cardiovascular mortality and prevent treatment disruption."

Congestive Heart Failure • Genito-urinary Cancer • Heart Failure • Hypertension • Oncology • Prostate Cancer • Solid Tumor

Spontaneous Remission of Primary Aldosteronism with Mineralocorticoid Receptor Antagonism (KIDNEY WEEK 2025) - "Eplerenone was replaced with spironolactone at that time. Treatment with an MRA, lead to biochemical remission for 4 years after ending therapy. Our findings add to reports identifying patients with spontaneous partial or complete remission of PA with MRA use and highlight the importance of continued surveillance of possible spontaneous remission in these patients."

Clinical • Cardiovascular • Chronic Kidney Disease • Dyslipidemia • Endocrine Disorders • Hypertension • Nephrology • Renal Disease

Adult-Onset Classic Bartter Syndrome Type 3 with Polycythemia: Rare Presentation in Siblings with Eight-Year Follow-Up (KIDNEY WEEK 2025) - "He required 830–850 mEq/day of oral potassium in addition to eplerenone. He did not tolerate spironolactone, amiloride and indomethacin due to their side effects...This case highlights the importance of genetic testing, tailored treatment, and awareness of rare associations like polycythemia in BS. Lifelong follow-up is crucial due to the risks of CKD and nephrocalcinosis."

Clinical • Chronic Kidney Disease • Metabolic Disorders • Nephrology • Renal Disease • SLC2A3

Initiation of SGLT2 inhibitors versus mineralocorticoid receptor antagonists as third-line therapy in heart failure with reduced ejection fraction: a nationwide cohort study. (PubMed, Lancet Reg Health Eur) - "The study included 4185 new MRA users (63% spironolactone, 37% eplerenone) and 2565 new SGLT2 inhibitor users (74% dapagliflozin, 26% empagliflozin). These findings support the prioritization of SGLT2 inhibitors in treatment sequencing for HFrEF. This study was supported by the Novo Nordisk Foundation and Karolinska Institutet."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Budget Impact Analysis of Eplerenone For the Management of Heart Failure With Reduced Ejection Fraction (HFrEF) in Italy (ISPOR-EU 2025) - "Among these, eplerenone has demonstrated a more favorable risk-benefit profile versus spironolactone and potassium canrenoate. Scaling up eplerenone use in eligible HFrEF patients is supported by recent evidence and demonstrates cost-saving potential for the Italian NHS. The model underscores hospitalization prevention as a key cost driver and highlights the importance of regional planning when implementing value-based therapies in heart failure management."

HEOR • Cardiovascular • Congestive Heart Failure • Heart Failure • Renal Disease

EVATRAN (The Effect of Eplerenone on the Evolution of Vasculopathy in Renal Transplant Patients): study protocol for a cross-over randomized controlled trial. (PubMed, Trials) - P3 | "CNI are a key component of immunosuppressive therapy in KT patients. By limiting vascular toxicity through MR blockade, CV risk in these patients may be reduced."

Journal • Acute Kidney Injury • Cardiovascular • Transplantation

MR Antagonist and LSD1 (clinicaltrials.gov) - P4 | N=300 | Active, not recruiting | Sponsor: Brigham and Women's Hospital | Recruiting ➔ Active, not recruiting

Enrollment closed • Cardiovascular • Hypertension

Detection of Diffuse Scar in Patients With Diabetes (clinicaltrials.gov) - P4 | N=0 | Withdrawn | Sponsor: Brigham and Women's Hospital | Phase classification: P1 ➔ P4 | N=50 ➔ 0 | Unknown status ➔ Withdrawn

Biomarker • Enrollment change • Phase classification • Trial withdrawal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Diabetes • Fibrosis • Metabolic Disorders • Type 2 Diabetes Mellitus

In brief: Primary aldosteronism screening in patients with hypertension. (PubMed, Med Lett Drugs Ther) - No abstract available

Journal • Cardiovascular • Endocrine Disorders • Hypertension

Prescription Drug Coverage of Guideline-Directed Medical Therapy for People Living with Heart Failure with Reduced Ejection Fraction in Canada. (PubMed, CJC Open) - "In all provincial and territorial plans, patient eligibility and prior medication use criteria are required for sacubitril-valsartan reimbursement...Carvedilol coverage is not a benefit in Ontario or British Columbia. Bisoprolol and spironolactone have universal coverage. Eplerenone is not listed in British Columbia. Dapagliflozin coverage is a benefit in all plans except Quebec. Ivabradine coverage has patient eligibility and prior medication use criteria in all provinces and territories and prescriber restrictions in certain regions...Coverage criteria include prior medication use and prescriber qualifications, which are not supported by evidence-based guidelines. Systemwide changes in the funding of drug reimbursement programs are needed to improve access to GDMT for the more than 750,000 people living with HF in Canada."

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Safety and Efficacy of the Aldosterone Synthase Inhibitor Osilodrostat in Primary Hypertension: A Retrospective Cohort Analysis (AHA 2025) - "BackgroundOsilodrostat, the first-generation aldosterone synthase inhibitor, lowered aldosterone and blood pressure in phase II studies, but its real-world safety and efficacy in primary hypertension remain undefined.MethodsWe used the TriNetX Global Collaborative Network to identify adults (≥18 years) initiating osilodrostat between 1 June 2020 and 30 April 2024, requiring a diagnosis of essential hypertension in the prior year and excluding secondary hypertension, spironolactone/eplerenone/finerenone use within 90 days, or pregnancy in the previous 6 months. Kaplan–Meier estimates showed overall survival of 97.5% at both 4 and 8 weeks, 96.2% at 24 weeks, and 90.8% at 52 weeks; freedom from hypokalemia was 91.2% at day 28 and 89% at day 56, AKI-free survival 96.1% at day 168 and 92.1% at day 365, hyperkalemia-free survival 96.2% at day 168, and serious adverse-event-free survival 70.6% at day 168 and 58.6% at day 365.ConclusionIn 80 adults treated with osilodrostat,..."

Retrospective data • Acute Kidney Injury • Cardiovascular • Hypertension • Nephrology • Renal Disease