Comparison of two mineralcorticosteroids receptor antagonists for the treatment of central serous chorioretinopathy.

Details

Serval ID
serval:BIB_437A62C15B6D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of two mineralcorticosteroids receptor antagonists for the treatment of central serous chorioretinopathy.
Journal
International ophthalmology
Author(s)
Pichi F., Carrai P., Ciardella A., Behar-Cohen F., Nucci P.
Working group(s)
Central Serous Chorioretinopathy Study Group
ISSN
1573-2630 (Electronic)
ISSN-L
0165-5701
Publication state
Published
Issued date
10/2017
Peer-reviewed
Oui
Volume
37
Number
5
Pages
1115-1125
Language
english
Notes
Publication types: Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
To evaluate the effect of oral spironolactone and eplerenone, two specific antagonists of the mineralocorticoid receptor, in central serous chorioretinopathy (CSCR).
In this prospective, placebo-controlled trial, sixty patients with persistent CSCR were assigned to three treatment group. Twenty patients in Group 1 were treated with 25 mg of spironolactone (Aldactone; Pfizer) for 1 week, then increased to 50 mg for the following 3 weeks, then shifted to eplerenone 50 mg for 1 month. Twenty patients in Group 2 were treated with 25 mg of eplerenone (Inspra; Pfizer) for 1 week, then increased to 50 mg for the following 3 weeks, and then shifted to spironolactone 50 mg for 1 month. Twenty patients in Group 3 were treated with 1 placebo control tablet for 1 week, then increased to two tablets for the following 3 weeks, and then shifted to spironolactone 50 mg for 1 month. At the end of the second month, all the treatments were stopped, and the patients were followed for two additional months. Primary outcome measure was a change in BCVA at 1, 2, and 4 months. Secondary outcome was a change of >20 % in the size of SRF recorded with OCT at 1, 2, and 4 months of treatment.
In terms of BCVA, treatment in Group 1 was effective from the first month (spironolactone, p value 0.01), and in Group 2 effective from the second month (shift to spironolactone, p value 0.004). Since the p value after the first month was 0.2 in Group 2, even with a larger sample, it would be difficult to see an efficacy of an eplerenone treatment after 1 month. As for the SRF, both in Group 1 and Group 2, both treatments were found to be equally effective after 1 month of administration (p values 0.004). At 4 months, only in Group 3, there was no statistical improvement of BCVA and SRF (p values 0.09 and 0.5).
Spironolactone is statistically superior to eplerenone in improving BCVA of patients with CSCR, while both drugs can be considered equally effective in promoting the reabsorption of SRF.
Keywords
Adult, Aged, Aged, 80 and over, Central Serous Chorioretinopathy/diagnosis, Central Serous Chorioretinopathy/drug therapy, Central Serous Chorioretinopathy/physiopathology, Dose-Response Relationship, Drug, Drug Administration Schedule, Eplerenone/administration & dosage, Female, Fluorescein Angiography/methods, Follow-Up Studies, Fundus Oculi, Humans, Intravitreal Injections, Male, Middle Aged, Mineralocorticoid Receptor Antagonists/administration & dosage, Prospective Studies, Spironolactone/administration & dosage, Tomography, Optical Coherence/methods, Treatment Outcome, Visual Acuity, Central serous chorioretinopathy, Eplerenone, Mineralocorticoid, Spironolactone
Pubmed
Web of science
Create date
01/11/2016 19:38
Last modification date
20/08/2019 13:47
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