UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000037304
Receipt number R000042530
Scientific Title A Comparison between Confirmatory Tests for the Diagnosis of Primary Aldosteronism
Date of disclosure of the study information 2019/07/29
Last modified on 2020/07/08 12:13:22

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Basic information

Public title

A Comparison between Diagnostic Tests for Primary Aldosteronism

Acronym

PA Diagnostic Tests Comparison

Scientific Title

A Comparison between Confirmatory Tests for the Diagnosis of Primary Aldosteronism

Scientific Title:Acronym

PA Confirmatory Tests Comparison

Region

Japan


Condition

Condition

Primary Aldosteronism

Classification by specialty

Endocrinology and Metabolism

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

Primary aldosteronism (PA) represents 3-10% of all hypertensive patients. The diagnosis of PA is important, because patients with PA have higher cardiovascular morbidity than patients with essential hypertension. Based on the Consensus Statement on the Clinical Practice of Primary Aldosteronism in Japan published by the Japan Endocrine Society in 2016, PA is diagnosed if one of following four confirmatory tests is positive; the captopril challenge test (CCT), furosemide-upright test (FUP), saline infusion test (SIT), or oral salt-loading test (OST). Because there are no evidences on which confirmatory test is superior than others in terms of sensitivity and specificity, we cannot completely deny PA until all the four tests have been confirmed to be negative. This might be problematic for physicians to diagnose PA for patients referred from general practitioners. In the present study, we analyze correlations among parameters of the four confirmatory tests and compare clinical characteristics between test-positive and test-negative patients for each confirmatory test. This would lead to the simplification of PA diagnosis and the proposal of diagnostic procedure that is appropriate for the clinical condition of each patient.

Basic objectives2

Others

Basic objectives -Others

Comparisons among parameters of different diagnostic tests

Trial characteristics_1

Others

Trial characteristics_2

Pragmatic

Developmental phase

Not applicable


Assessment

Primary outcomes

Comparisons among post-CCT aldosoterone/renin ratio (ARR), plasma aldosterone concentration (PAC), post/pre-CCT PAC ratio, post-FUP plasma renin activitiy (PRA), post-SIT PAC, and post-OST urinary aldosterone excretion.

Key secondary outcomes

Concordance among confirmatory test results. Adverse events in each confirmatory test. Clinical characteristics of test-positive patients among confirmatory tests.


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit


Not applicable

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

(1) patients for whom at least two of the CCT, SIT, FUP, and oral salt-loading test were performed, (2) patients who did not refuse to be included in the study upon information disclosure of the study on the Web site of Shizuoka General Hospital.

Key exclusion criteria

(1) patients for whom less than two of the confirmatory tests were performed, (2) patients who refused to be included in the study upon information disclosure of the study.

Target sample size

200


Research contact person

Name of lead principal investigator

1st name Naohisa
Middle name
Last name Tamura

Organization

Shizuoka General Hospital

Division name

Research Support Center

Zip code

420-8527

Address

4-27-1 Kita Ando, Aoi-ku, Shizuoka City, Japan 420-8527

TEL

054-247-6111

Email

naohisa-tamura@i.shizuoka-pho.jp


Public contact

Name of contact person

1st name Naohisa
Middle name
Last name Tamura

Organization

Shizuoka General Hospital

Division name

Research Support Center

Zip code

420-8527

Address

4-27-1 Kita Ando, Aoi-ku, Shizuoka City, Japan 420-8527

TEL

054-247-6111

Homepage URL


Email

naohisa-tamura@i.shizuoka-pho.jp


Sponsor or person

Institute

Department of Hypertension Research
Research Support Center
Shizuoka General Hospital

Institute

Department

Personal name



Funding Source

Organization

Self funding

Organization

Division

Category of Funding Organization

Self funding

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Clinical Research Ethics Committee, Shizuoka General Hospital

Address

4-27-1 Kita Ando, Aoi-ku, Shizuoka City

Tel

054-247-6111

Email

chiken-sougou@shizuoka-pho.jp


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions

静岡県立総合病院(静岡県)


Other administrative information

Date of disclosure of the study information

2019 Year 07 Month 29 Day


Related information

URL releasing protocol


Publication of results

Published


Result

URL related to results and publications


Number of participants that the trial has enrolled

142

Results

The plasma aldosterone concentration 60 min after the load of CCT (CCT60-PAC) <=59.0 pg/mL and CCT60-plasma renin activity (PRA) >=1.05 ng/mL/h could predict negativities of SIT and FUP, respectively, with >95% specificities. The present study suggested the SIT as the next test to be done if the CCT-negative patient belonged to the subset with CCT60-PAC >59.0 pg/mL and CCT60-PRA >=1.05 ng/mL/h, otherwise the FUP should be selected.

Results date posted

2020 Year 07 Month 08 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results

2020 Year 04 Month 03 Day

Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2017 Year 08 Month 10 Day

Date of IRB

2017 Year 08 Month 10 Day

Anticipated trial start date

2017 Year 08 Month 11 Day

Last follow-up date

2019 Year 07 Month 08 Day

Date of closure to data entry


Date trial data considered complete


Date analysis concluded



Other

Other related information

Comparisons among post-CCT aldosoterone/renin ratio (ARR), plasma aldosterone concentration (PAC), post/pre-CCT PAC ratio, post-FUP plasma renin activitiy (PRA), post-SIT PAC, and post-OST urinary aldosterone excretion.
Concordance among confirmatory test results, adverse events in each confirmatory test, and clinical characteristics of test-positive patients among confirmatory tests are also analyzed.


Management information

Registered date

2019 Year 07 Month 08 Day

Last modified on

2020 Year 07 Month 08 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042530


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name