Effect of eplerenone on markers of bone turnover in patients with primary hyperparathyroidism: the randomized, placebo-controlled EPATH trial

Mineralocorticoid receptor (MR) antagonism may affect bone turnover via direct and indirect pathways involving parathyroid hormone, but randomized controlled trials are lacking. In a pre-specified analysis of the “Eplerenone in primary hyperparathyroidism” placebo-controlled, randomized trial (ISRCT...

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Bibliographic Details
Main Authors: Verheyen, Nicolas (Author) , März, Winfried (Author)
Format: Article (Journal)
Language:English
Published: 2017
In: Bone
Year: 2017, Volume: 105, Pages: 212-217
ISSN:1873-2763
DOI:10.1016/j.bone.2017.08.030
Online Access:Verlag, Volltext: http://dx.doi.org/10.1016/j.bone.2017.08.030
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S8756328217303253
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Author Notes:Nicolas Verheyen, Martin R. Grübler, Andreas Meinitzer, Christian Trummer, Verena Schwetz, Karin Amrein, Hans P. Dimai, Winfried März, Cristiana Catena, Dirk von Lewinski, Jakob Voelkl, Ioana Alesutan, Astrid Fahrleitner-Pammer, Helmut Brussee, Stefan Pilz, Andreas Tomaschitz

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520 |a Mineralocorticoid receptor (MR) antagonism may affect bone turnover via direct and indirect pathways involving parathyroid hormone, but randomized controlled trials are lacking. In a pre-specified analysis of the “Eplerenone in primary hyperparathyroidism” placebo-controlled, randomized trial (ISRCTN 33941607), effects of eight weeks MR-blockade with eplerenone on bone turnover markers in 97 patients with primary hyperparathyroidism were tested. Mean age was 67.5±9.5years, and 76 (78.4%) were females. In analysis of covariance with adjustment for baseline values, eplerenone had no significant effect on isoform 5b of the tartrate-resistant acid phosphatase (TRAP), beta-crosslaps, N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin and bone-specific alkaline phosphatase. There was no significant cross-sectional correlation between plasma aldosterone concentration or the aldosterone-to-renin ratio and markers of bone turnover in multivariate linear regression models at baseline. These data provide first evidence from a randomized and placebo-controlled trial that short-term MR antagonism may not affect bone turnover, at least in patients with primary hyperparathyroidism. 
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