Drug intelligence / Profile preview

renin-angiotensin blockers + spironolactone

Development stage
Unknown
Lead developer
James A. Tumlin
Modality
Small Molecules
Administration
Oral
01

Overview

Renin-angiotensin (RAAS) blockers + spironolactone is a combination therapeutic regimen investigated for the treatment of Type 2 Diabetic Nephropathy. The regimen involves the use of maximal doses of RAAS inhibitors—either Angiotensin-Converting Enzyme (ACE) inhibitors like lisinopril or Angiotensin II Receptor Blockers (ARBs) like losartan—in conjunction with spironolactone, a steroidal mineralocorticoid receptor antagonist (MRA). The primary therapeutic objective is to achieve superior reduction in proteinuria and albuminuria and to slow the progression of chronic kidney disease (CKD) by more completely blocking the aldosterone escape phenomenon. Due to the high risk of hyperkalemia associated with dual RAAS and MRA blockade, clinical evaluation of this regimen (such as the MRA-ACE trial) often incorporates the use of potassium binders like patiromer to manage electrolyte imbalances.

Other names
MRA-ACEspironolactone + ACE inhibitorspironolactone + ARB
02

Targets

ACE (Angiotensin Converting Enzyme)PR (Progesterone receptor)MR (Mineralocorticoid receptor)PPARG (Peroxisome proliferator-activated receptor gamma)REN (Renin)GR (Glucocorticoid receptor)AR (Adrenergic receptors)AGTR1 (Angiotensin II Type-1 receptor)

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