eplerenone / Generic mfg. - LARVOL DELTA

COMPARATIVE EFFECTIVENESS OF GLP-1RAS VS. MRAS AS FOURTH-LINE THERAPY FOR RESISTANT HYPERTENSION (ISN-WCN 2026) - "This study aims to compare the effectiveness of GLP-1RAs (semaglutide and tirzepatide) and mineralocorticoid receptor antagonists (MRAs, spironolactone and eplerenone) in reducing major adverse cardiovascular effect (MACE) among individuals with resistant hypertension.Methods The comparative effectiveness study included adults with Body-Mass-Index (BMI) ≥ 27 kg/m2 and resistant hypertension identified from TriNetX database who initiated treatment between June 1, 2017, and March 31, 2025. The systolic blood pressure-lowering effect was comparable between the two cohorts (GLP1-1RAs: -3.9 mmHg, 95%CI [-5.2 to -2.6]; MRAs: -5.1 mmHg, 95%CI [-6.3 to -3.9]).Conclusion In this study, GLP-1RAs treatment was associated with a significantly lower risk of MACE, while demonstrating a comparable blood pressure-lowering effect to MRAs treatment. These findings underscore the potential benefit of integrating GLP-1RAs into the standard of care for obese patients with resistant..."

HEOR • Cardiovascular • Hypertension • Obesity

RECURRENT PARALYTIC ILEUS ASSOCIATED WITH TIRZEPATIDE ADMINISTRATION IN A 72-YEAR-OLD MALE AFTER ROBOT-ASSISTED RADICAL CYSTECTOMY WITH ILEAL CONDUIT CONSTRUCTION (ISN-WCN 2026) - "Two and a half years earlier, he was diagnosed with low-grade papillary urothelial carcinoma with early invasion and underwent five transurethral resections of bladder tumor (TUR-Bt) over 1.5 years.His medications included rosuvastatin, hydrochlorothiazide, eplerenone 50 mg, telmisartan 80 mg, amlodipine 5 mg, and glucose-lowering agents: dapagliflozin 10 mg, glimepiride, sitagliptin 50 mg, insulin glargine, and insulin human R. One week before surgery, insulin and oral glucose-lowering agents were replaced with tirzepatide 2.5 mg weekly...Chronic kidney disease alters drug pharmacokinetics and intestinal sensitivity [5], potentially amplifying GLP-1RA/GIP effects. These factors highlight the need for preventive measures against postoperative adhesions and electrolyte disturbances with acidosis."

Bladder Cancer • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Hypertension • Metabolic Disorders • Nephrology • Renal Disease • Solid Tumor • Type 2 Diabetes Mellitus • Urology • Urothelial Cancer

A CASE OF GITELMAN SYNDROME COMPLICATED BY FAMILIAL CHRONIC INTESTINAL PSEUDO-OBSTRUCTION AND REFRACTORY ELECTROLYTE IMBALANCE (ISN-WCN 2026) - "Despite high-dose oral potassium chloride (96 mEq/day), magnesium oxide, and eplerenone, serum potassium remained 2.5–3.0 mEq/L and magnesium 0.5–1.0 mEq/L...Overlapping renal and intestinal defects led to persistent hypokalemia, hypomagnesemia, and hypocalcemia necessitating continuous intravenous replacement and coordinated multidisciplinary management.Conclusion This rare coexistence of Gitelman syndrome and chronic intestinal pseudo-obstruction resulted in a severe clinical course. Intestinal failure amplified the metabolic consequences of GS, rendering electrolyte control difficult and underscoring the need for multidisciplinary management in such complex hereditary disorders."

Clinical • Endocrine Disorders • Gastrointestinal Disorder • Genetic Disorders • Metabolic Disorders • Nephrology • Rare Diseases • SLC2A3

Eplerenone-induced maculopapular type drug eruption. (PubMed, Eur J Dermatol) - No abstract available

Journal

Long-term follow-up of PLACE and SPECTRA trials: outcomes after successful and unsuccessful half-dose photodynamic therapy for chronic central serous chorioretinopathy. (PubMed, Am J Ophthalmol) - "cCSC patients with a successful first PDT show better long-term clinical outcomes than those with an unsuccessful first PDT. Notably, BCVA remained stable in both groups from the first follow-up after half-dose PDT onward, which is a reassuring finding even for patients without initial treatment success."

Journal • Diabetic Retinopathy • Retinal Disorders

Real-World Benefit of Spironolactone and Eplerenone in HFpEF: Evidence From a Large-Scale Observational Study. (PubMed, Am J Ther) - No abstract available

Journal • Observational data • Real-world evidence • Cardiovascular

COMPARATIVE EFFICACY AND SAFETY OF SPIRONOLACTONE, EPLERENONE, CANRENONE, AND FINERENONE IN HEART FAILURE WITH REDUCED EJECTION FRACTION: A NETWORK META-ANALYSIS OF RANDOMIZED TRIALS (ACC 2026) - "MRAs are effective in HFrEF with distinct efficacy and safety profiles; overall risk of bias across included trials was low."

Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure • Renal Disease

CLINICAL OUTCOMES AMONG HFPEF PATIENTS ON SPIRONOLACTONE VS EPLERENONE: A REAL WORLD PROPENSITY MATCHED ANALYSIS (ACC 2026) - "Eplerenone was associated with superior outcomes versus spironolactone in HFpEF, warranting confirmation in prospective trials."

Clinical • Clinical data • Real-world • Real-world evidence • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction

NON-OBSTRUCTIVE HYPERTROPHIC CARDIOMYOPATHY IN EARLY BURNOUT PHASE: A DIAGNOSTIC CHALLENGE (ACC 2026) - "Initial therapy included furosemide, dapagliflozin, sacubitril valsartan, and eplerenone, with referral to electrophysiology for implantable defibrillator placement. Hypertrophic cardiomyopathy is frequent yet underdiagnosed. The "burnout" phase has prognostic impact, with transplantation as the only proven therapy. In this case, medical treatment of heart failure improved ejection fraction, highlighting the value of optimized therapy."

Asthma • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Diabetes • Genetic Disorders • Heart Failure • Hypertension • Hypertrophic Cardiomyopathy • Immunology • Metabolic Disorders • Non-obstructive Hypertrophic Cardiomyopathy • Respiratory Diseases

EFFECT OF CHRONIC MINERALOCORTICOID RECEPTOR ANTAGONIST USE ON POST-MYOCARDIAL INFARCTION COMPLICATIONS (ACC 2026) - "Exposure was spironolactone or eplerenone documented in the EHR (orders/active medication list) within 90 days before index MI; controls had no MRA in that window...We excluded ESRD, autoimmune disease, malignancy, prior pericarditis, and prior colchicine... Antecedent MRA use was associated with lower 90-day pericarditis, mortality, VTE, and CRP after MI. The consistency and direction of effects support a plausible anti-inflammatory/thrombo-modulatory signal; however, these hypothesis-generating findings require confirmation in prospective studies with verified exposure/adherence and standardized outcome adjudication."

Cardiovascular • Chronic Kidney Disease • Immunology • Myocardial Infarction • Renal Disease • Venous Thromboembolism

SAFETY OF MINERALOCORTICOID RECEPTOR ANTAGONISTS IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 4-5: A RETROSPECTIVE REVIEW (ACC 2026) - "Eligible patients were those with an eGFR <30 mL/min/1.73 m² who were prescribed spironolactone, eplerenone, or finerenone and had a history of heart failure, hypertension, hyperaldosteronism, and/or diabetic kidney disease between January 1, 2021, and September 30, 2024. This ongoing study will provide real-world safety data on MRA use in CKD stage 4-5 patients not receiving dialysis, helping to guide clinical practice in this population."

Metastases • Retrospective data • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetic Nephropathy • Endocrine Disorders • Heart Failure • Hepatology • Hypertension • Nephrology • Renal Disease

COMPARATIVE EFFECTIVENESS AND SAFETY OF SPIRONOLACTONE VERSUS EPLERENONE IN PATIENTS WITH HFREF AND CHRONIC KIDNEY DISEASE: A REAL-WORLD PROPENSITY-MATCHED ANALYSIS (ACC 2026) - "In a large real-world CKD-HFrEF cohort, eplerenone was associated with lower rates of hyperkalemia, progression to advanced HF, and hospitalization compared to spironolactone, with no difference in mortality or MACE. These findings support preferential consideration of eplerenone in CKD patients with HFrEF where clinically feasible."

Clinical • HEOR • Real-world • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

Human 3D Cardiac Microtissue Model to Investigate Aldosterone-Induced Fibrosis and Electrical Dysfunction. (PubMed, Hypertension) - "hMT were treated with aldosterone, the mineralocorticoid receptor antagonist eplerenone, and serum from patients with primary aldosteronism or matched subjects with essential hypertension...3D hMT organoids offer a relevant in vitro model to study aldosterone-mediated cardiac effects. Aldosterone directly induces fibrosis and prolongation of the QT interval in this model, which may partially explain the increase of cardiovascular risk in patients with primary aldosteronism and underscores the benefit of mineralocorticoid receptor antagonist therapy."

Journal • Cardiovascular • Endocrine Disorders • Fibrosis • Hypertension • Immunology • KCNQ1OT1

Finerenone, Eplerenone, and Spironolactone in HFpEF: A Bayesian Network Meta-Analysis of Efficacy and Safety. (PubMed, Eur J Heart Fail) - "In HFpEF/HFmrEF, finerenone was the only MRA to significantly reduce hospitalization for HF, while no agent significantly reduced cardiovascular mortality and hyperkalemia risk increased across therapies. Overall, finerenone may offer the most favorable efficacy-safety balance among MRAs, pending confirmation in larger dedicated trials."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Heart Failure

The Pharmacological Properties and Safety Profile of Mineralocorticoid Receptor Antagonists in Heart Failure with Reduced Ejection Fraction. (PubMed, J Assoc Physicians India) - "Among the established mineralocorticoid receptor antagonists (MRAs), spironolactone and eplerenone have demonstrated significant clinical utility in managing conditions such as chronic heart failure, resistant hypertension, and hyperaldosteronism. This review explores the pharmacokinetic and pharmacodynamic profiles of these agents, highlighting their mechanisms of action, receptor-binding characteristics, and clinical implications. The safety considerations associated with long-term use, particularly hyperkalemia and renal function impairment, are also discussed to provide a comprehensive understanding of their therapeutic roles."

Journal • Review • Cardiovascular • Congestive Heart Failure • Endocrine Disorders • Heart Failure • Hypertension

Risk of Delaying or Omitting Mineralocorticoid Receptor Antagonists in Heart Failure. (PubMed, J Assoc Physicians India) - "MRAs, including spironolactone and eplerenone, provide significant morbidity and mortality benefits, particularly when introduced early in high-risk scenarios such as acute myocardial infarction (AMI) and acute decompensated heart failure (ADHF). Clinical evidence demonstrated that early aldosterone blockade exerts rapid and sustained benefits, often within days of initiation. Early initiation and aggressive optimization of MRAs must be prioritized in HFrEF management to fully realize their life-saving potential."

Journal • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction

Mineralocorticoid Receptor Antagonists: An Overview of History and Evolution. (PubMed, J Assoc Physicians India) - "Steroidal MRAs, such as spironolactone and eplerenone, effectively suppress mineralocorticoid receptor activation but are associated with side effects like hyperkalemia and endocrine abnormalities. Current research aims to optimize MRAs further for broader therapeutic applications, including nondiabetic kidney and cardiovascular diseases, and to improve safety profiles. In this review, we reflect on the historical development, classification, evolution, major clinical trials, and future prospects of MRAs."

Journal • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetic Nephropathy • Heart Failure • Hypertension • Nephrology • Renal Disease

Mineralocorticoid Receptor Antagonists: The Pillar Drug in Heart Failure. (PubMed, J Assoc Physicians India) - "Spironolactone, though potent, is associated with hormonal side effects due to its nonselective receptor binding, while eplerenone offers improved tolerability through greater receptor specificity. This review explores the pharmacological mechanisms, clinical trial evidence, and safety considerations of steroidal MRAs, underscoring their indispensable role in comprehensive HF therapy."

Journal • Review • Cardiovascular • Congestive Heart Failure • Fibrosis • Heart Failure • Immunology • Myocardial Infarction

AIFA-CARDIO-129: Pharmacological optimization in prevention in Heart Failure: A Sex-gap? (clinicaltrialsregister.eu) - P4 | N=368 | Not yet recruiting | Sponsor: Policlinico San Donato S.p.A.

New P4 trial • Cardiovascular • Congestive Heart Failure • Heart Failure

Anthracyclines and the Heart: A Double-edged Sword With Therapeutic Hopes. (PubMed, J Saudi Heart Assoc) - "Anthracyclines, notably doxorubicin, are potent cytotoxic agents that substantially improved outcomes across numerous malignancies...Neurohormonal modulation with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and β-blockers has shown modest preservation of left ventricular ejection fraction, especially when initiated early in high-risk patients; spironolactone appears more effective than eplerenone among mineralocorticoid receptor antagonists. Sacubitril/valsartan demonstrates promising superiority in preclinical and early clinical cohorts, though further randomised control trials are ongoing. Metabolic modulators such as metformin and sodium-glucose cotransporter 2 inhibitors exhibit cardio-protectivity via AMPK activation, attenuation of oxidative and inflammatory pathways, but evidence in non-diabetic cancer populations is limited. Statins have shown reduced left ventricular ejection fraction decline and lower cardiotoxicity rates in..."

Journal • Review • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Heart Failure • Metabolic Disorders • Oncology • Pediatrics

Diurnal rhythm in blood pressure is preserved in hypertensive mice despite therapy with mineralocorticoid receptor antagonists. (PubMed, J Cardiovasc Pharmacol) - "Thus, L-NAME causes hypertension in mice and induces a "non-dipper" phenotype in most of the mice. Spironolactone, eplerenone or finerenone at the selected doses do not change arterial blood pressure in hypertensive mice."

Journal • Preclinical • Cardiovascular • Hypertension

Eplerenone in Patients Undergoing REnal Transplant (EPURE TRANSPLANT) (clinicaltrials.gov) - P3 | N=132 | Recruiting | Sponsor: Central Hospital, Nancy, France | Not yet recruiting ➔ Recruiting | Initiation date: May 2016 ➔ Oct 2016

Enrollment open • Trial initiation date • Chronic Kidney Disease • Nephrology • Transplantation

Eplerenone in Patients Undergoing REnal Transplant (EPURE TRANSPLANT) (clinicaltrials.gov) - P3 | N=132 | Not yet recruiting | Sponsor: Central Hospital, Nancy, France | Initiation date: Nov 2015 ➔ May 2016 | Trial primary completion date: Aug 2019 ➔ Aug 2020

Trial initiation date • Trial primary completion date • Chronic Kidney Disease • Nephrology • Transplantation

Eplerenone in Patients Undergoing REnal Transplant (EPURE TRANSPLANT) (clinicaltrials.gov) - P3 | N=132 | Not yet recruiting | Sponsor: Central Hospital, Nancy, France

New P3 trial • Chronic Kidney Disease • Nephrology • Transplantation

Eplerenone in Patients Undergoing REnal Transplant (EPURE TRANSPLANT) (clinicaltrials.gov) - P3 | N=132 | Active, not recruiting | Sponsor: Central Hospital, Nancy, France | Recruiting ➔ Active, not recruiting | Trial completion date: Jul 2030 ➔ Aug 2031

Enrollment closed • Trial completion date • Chronic Kidney Disease • Nephrology • Transplantation