Evidence map›Paper›PMID 32452085›Full record

Trial reportEuropean journal of heart failure2020

Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): results in the pre-specified subgroup with heart failure.

Patrick Rossignol, Bryan Williams, Martha R Mayo, Suzette Warren, Susan Arthur, Gail Ackourey, William B White, Rajiv Agarwal

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European journal of heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 4 pooled it
3.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 4 syntheses or guidelines pooled it, 54 citations in OpenAlex.

  1. Pooled it
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  4. Pooled it
  5. Trial
  6. Trial
  7. Article
  8. Article
  9. Review
  10. Mineralocorticoid Receptor and Sleep Quality in Chronic Kidney Disease.International journal of molecular sciences · 2024
    Review
  11. Article
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  18. Article
  19. Hyperkalemia in Chronic Kidney Disease: Links, Risks and Management.International journal of nephrology and renovascular disease · 2022
    Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 3 countries.

Patrick RossignolUniversité de Lorraine, Inserm 1433 CIC-P CHRU de Nancy, Inserm U1116 and FCRIN INI-CRCT, Nancy, France.
Bryan WilliamsInstitute of Cardiovascular Science University College London (UCL) and National Institute for Health Research (NIHR) UCL/UCL Hospitals Biomedical Research Centre, London, UK.
Martha R MayoRelypsa, Inc., a Vifor Pharma Group Company, Redwood City, CA, USA.
Suzette WarrenRelypsa, Inc., a Vifor Pharma Group Company, Redwood City, CA, USA.
Susan ArthurRelypsa, Inc., a Vifor Pharma Group Company, Redwood City, CA, USA.
Gail AckoureyRelypsa, Inc., a Vifor Pharma Group Company, Redwood City, CA, USA.
William B WhiteCalhoun Cardiology Center, University of Connecticut School of Medicine, Farmington, CT, USA.
Rajiv AgarwalDepartment of Medicine, Division of Nephrology, Indiana University School of Medicine, Indianapolis, IN, USA.
Vifor Pharma (United States) · USCalhoun Community College · USFrench Clinical Research Infrastructure Network · FRUCL Biomedical Research Centre · GBUniversity School · US

Funding

Medical Research Council MC_PC_13090
6 · The paper itself

Abstract

aimsThe AMBER trial demonstrated that concomitant use of patiromer enabled the more persistent use of spironolactone by reducing the risk of hyperkalaemia in patients with resistant hypertension and advanced chronic kidney disease. We report herein the pre-specified subgroup analysis in patients with heart failure (HF). METHODS AND

resultsParticipants were randomly assigned (1:1) to receive either placebo or patiromer (8.4 g once daily), in addition to open-label spironolactone (starting at 25 mg once daily) and their baseline blood pressure medications. Dose titrations were permitted after 1 week for patiromer/placebo and after 3 weeks for spironolactone. The primary endpoint was the between-group difference at week 12 in the proportion of patients on spironolactone. Efficacy endpoints and safety were assessed in all randomized patients (intention to treat). A total of 295 patients were enrolled, of whom 132 (45%) had HF. In the HF subgroup, 68.1% of patients receiving placebo remained on spironolactone at week 12, compared with 84.1% of patients receiving patiromer (P = 0.0504). The reason for discontinuation from spironolactone use was hyperkalaemia in the majority of both groups. There was no significant interaction between the subgroups with HF and without HF (P = 0.8085) for the primary endpoint.

conclusionsConsistent with the overall AMBER trial results, this pre-specified subgroup analysis in patients with HF, resistant hypertension and advanced chronic kidney disease demonstrated that patiromer enabled more persistent use of spironolactone by reducing the risk of hyperkalaemia.

Indexed as

Heart FailureHypertensionRenal Insufficiency, ChronicAgedAmberFemaleHumansHyperkalemiaMaleMineralocorticoid Receptor AntagonistsPolymersPotassiumSpironolactoneTreatment OutcomeAmberMineralocorticoid Receptor AntagonistspatiromerPolymersPotassiumSpironolactoneChronic kidney diseaseHeart failureHyperkalaemiaPatiromerResistant hypertensionSpironolactone

Identifiers

PMID32452085
PMCPMC7540031
OpenAlexW3031829024

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.