Spironolactone + Chlorthalidone for High Blood Pressure

(LODESTAR Trial)

RA
Overseen ByRajiv Agarwal, MD MBBS
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: VA Office of Research and Development
Must be taking: Antihypertensives, ACE inhibitors, ARBs, Beta-blockers
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

The purpose of this research is to gather information on the safety and effectiveness of spironolactone and chlorthalidone for treatment of high blood pressure in patients with moderate to advanced CKD. Both drugs have been approved by the Food and Drug Administration (FDA) for the treatment of high blood pressure since 1960.

Who Is on the Research Team?

RA

Rajiv Agarwal, MD MBBS

Principal Investigator

Richard L. Roudebush VA Medical Center, Indianapolis, IN

Are You a Good Fit for This Trial?

This trial is for adults with moderate to advanced chronic kidney disease (CKD) who also have high blood pressure. People with other serious health issues or conditions that could interfere with the study may not be able to join.

Inclusion Criteria

Study is limited to US Veterans
GFR estimated by race-independent CKD-EPI formula less than 45 ml/min/1.73m2 but greater than or equal to 15 mL/min/1.73m2
Hypertension defined by clinic AOBP of at least 135/85
See 3 more

Exclusion Criteria

I have not used certain water pills or potassium drugs in the past 4 weeks.
I am not pregnant, breastfeeding, or planning pregnancy and use reliable contraception.
I have had an allergic reaction to CTD or spironolactone.
See 3 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks
1 visit (in-person)

Placebo Run-in

Participants undergo a patient-blind, placebo run-in period

2 weeks
1 visit (in-person)

Treatment Phase 2A

Participants are randomized to receive placebo, CTD very low dose, SPL very low dose, or a combination of CTD and SPL for 6 weeks

6 weeks
2 visits (in-person)

Dose Escalation Phase 2A

Doses are doubled for a further 6 weeks to assess the primary endpoint

6 weeks
2 visits (in-person)

Treatment Phase 2B

Participants receive CTD low dose, SPL low dose, or a combination of CTD and SPL for 12 weeks

12 weeks
3 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks
1 visit (in-person)

What Are the Treatments Tested in This Trial?

Trial Overview

The study is testing how safe and effective low doses of spironolactone, chlorthalidone, or a combination of both are at lowering blood pressure in people with CKD. Participants are assigned different treatments to compare results.

How Is the Trial Designed?

8

Treatment groups

Experimental Treatment

Active Control

Placebo Group

Group I: SpironolactoneExperimental Treatment1 Intervention
Group II: ChlorthalidoneExperimental Treatment1 Intervention
Group III: CTD + SPLExperimental Treatment1 Intervention
Group IV: 2B VLD CTD + VLD SPLExperimental Treatment1 Intervention
Group V: 2B LD CTD + LD SPLExperimental Treatment1 Intervention
Group VI: 2B CTDActive Control1 Intervention
Group VII: 2B SPLActive Control1 Intervention
Group VIII: placeboPlacebo Group3 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

Michael E. DeBakey VA Medical Center

Collaborator

Trials
68
Recruited
17,200+

VA Salt Lake City Health Care System

Collaborator

Trials
25
Recruited
262,000+