Spironolactone to Improve Apnea and Cardiovascular Markers in Obstructive Sleep Apnea Patients

NCT ID: NCT04205136

Last Updated: 2022-04-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

PHASE4

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-31

Study Completion Date

2023-04-30

Brief Summary

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The purpose of this study is to test whether Spironolactone can improve the severity of obstructive sleep apnea and improve cardiovascular biomarkers in people who are not regularly using their Positive Airway Pressure (PAP) therapy.

Detailed Description

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Conditions

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Obstructive Sleep Apnea

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The researchers will do a trial of spironolactone in 30 obstructive sleep apnea (OSA) patients with cardiovascular disease who are non-adherent with Positive Airway Pressure (PAP) therapy.
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators
Both groups will receive treatment as usual for obstructive sleep apnea. Spironolactone and placebo will be prescribed by one of the study physicians (who will not be blinded to treatment condition \["care provider"\]) .

Study Groups

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Spironolactone

Dose of 25 mg daily that may be titrated up to 50 mg daily, if tolerated and will receive treatment as usual for obstructive sleep apnea.

Group Type EXPERIMENTAL

Spironolactone

Intervention Type DRUG

If tolerated and serum potassium \<5.0 meq/L, the dose will be increased to 50 mg (2 pills) after 4 weeks. If serum potassium is \>5.0 but less than 5.5 or creatinine \>4.0 mg/dL, the dose will be adjusted to 25 mg every other day; if potassium levels ≥5.5 in a non-hemolyzed blood sample, the medication will be discontinued.

Placebo

Placebo and will receive treatment as usual for obstructive sleep apnea.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Subjects assigned to the placebo group will take one pill for the first 4 weeks and a second pill for the remaining 8 weeks.

Interventions

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Spironolactone

If tolerated and serum potassium \<5.0 meq/L, the dose will be increased to 50 mg (2 pills) after 4 weeks. If serum potassium is \>5.0 but less than 5.5 or creatinine \>4.0 mg/dL, the dose will be adjusted to 25 mg every other day; if potassium levels ≥5.5 in a non-hemolyzed blood sample, the medication will be discontinued.

Intervention Type DRUG

Placebo

Subjects assigned to the placebo group will take one pill for the first 4 weeks and a second pill for the remaining 8 weeks.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Body Mass Index (BMI) greater than or equal to 30
* Diagnosis of moderate to severe OSA via diagnostic polysomnography (AHI≥15) or home sleep apnea test (respiratory event index (REI)≥15).
* Diagnosis of cardiovascular disease
* Meet criteria for hypertension (minimum systolic blood pressure ≥ 140 but \<180)
* Prescribed PAP therapy but non-adherent (failure to use PAP for at least 4 hours per night on minimum 5/7 nights per week on average over a one-month period)

Exclusion Criteria

* Diagnosis of congestive heart failure; resistant hypertension; hepatic disease; Addison's disease; cancer; or recent (past 3 months) myocardial infarction, or stroke
* Diagnosis of central sleep apnea
* Patients who are not using PAP at all (untreated) or using another form of treatment for OSA
* Currently taking, recent trial (past month), or allergy for spironolactone
* Severe respiratory disease (e.g., diagnosis of chronic obstructive pulmonary disease, uncontrolled asthma)
* History of leukopenia and/or thrombocytopenia
* Current use of another potassium sparing diuretic (e.g., amiloride or eplerenone)
* Current use of lithium, barbiturates, narcotics, muscle relaxants, pressor amines, or cholestyramine
* Patients who plan to have surgery during the time period of the study
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Louise O'Brien

Research Associate Professor, Neurology, Research Associate Professor, Obstetrics and Gynecology, Medical School and Associate Research Scientist, Dentistry, Department of Oral and Maxillofacial Surgery, School of Dentistry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Louise O'Brien, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Bertram Pitt, MD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

J. Todd Arnedt, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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The University of Michigan

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

Other Identifiers

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HUM00147375

Identifier Type: -

Identifier Source: org_study_id

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