Spironolactone for Pulmonary Arterial Hypertension

This trial explores whether spironolactone, a medication often used for fluid retention and high blood pressure, can improve lung blood vessel function and reduce inflammation in people with pulmonary arterial hypertension (PAH), a condition characterized by high blood pressure in the lungs. Participants will receive either spironolactone or a placebo to determine its effectiveness. Those with PAH who have been stable on their current treatment for at least four weeks may be suitable for this trial. As a Phase 2 trial, this research focuses on assessing the treatment's effectiveness in an initial, smaller group, offering participants a chance to contribute to significant medical advancements.

The trial does not specify if you need to stop taking your current medications, but you must not have taken spironolactone or eplerenone in the last 30 days. Also, you cannot be on the maximum dose of ACE inhibitors or angiotensin II receptor blockers.

Research has shown that spironolactone is safe and generally well-tolerated by people with pulmonary arterial hypertension (PAH). In studies, patients taking spironolactone did not experience increased issues with high potassium levels or liver problems, common concerns with this type of medication. Regular check-ups help detect any potential side effects early. Overall, spironolactone has demonstrated a positive safety record for those with PAH.¹²³⁴⁵

Spironolactone is unique because, unlike traditional treatments for pulmonary arterial hypertension (PAH) that typically focus on dilating blood vessels or reducing blood pressure through prostacyclins and endothelin receptor antagonists, it acts as a mineralocorticoid receptor antagonist. This means it can help reduce inflammation and fibrosis in the heart and blood vessels. Researchers are excited about spironolactone because it targets underlying mechanisms of PAH, potentially offering a new angle of treatment that could complement existing therapies. By addressing these different pathways, spironolactone might improve outcomes for patients who don't fully respond to current medications.

Research has shown that spironolactone, which participants in this trial may receive, might be a helpful treatment for pulmonary arterial hypertension (PAH). Studies have found that spironolactone improves blood vessel function and reduces swelling. Some people with PAH have also found it helps manage fluid buildup. Additionally, spironolactone can help reduce tissue scarring. While more research is needed, early results suggest it could effectively ease PAH symptoms and improve patients' quality of life.²³⁶⁷⁸