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The EPOCH Study (Eplerenone on Top of ACE Inhibition in Chronic Kidney Disease Patients With Hypertension)

This study is currently recruiting participants.
Verified March 2016 by Marcus Saemann, Medical University of Vienna
ClinicalTrials.gov Identifier:
First Posted: April 16, 2013
Last Update Posted: March 16, 2016
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
Information provided by (Responsible Party):
Marcus Saemann, Medical University of Vienna
In a prospective single centre placebo-controlled trial over ten weeks, 24 CKD II-III patients (eGFR 30-89 ml/min per 1.73 m2) with DM II will be randomized to enalapril 20mg per day after a two week run-in phase. Thereafter, patients will either receive eplerenone 25mg (n=12) or a placebo (n=12) for eight weeks. Eplerenone will be increased to 50mg under close monitoring of serum potassium levels. Employing a novel mass-spectrometry ( MS)-based method, quantification of up to 10 different Ang metabolites (Ang I, Ang II, Ang 1-7, Ang 1-9, Ang 2-10, Ang 1-5, Ang 2-7, Ang 3-7, Ang 3-8 and Ang 2-8) will be performed simultaneously out of blood sera (after run-in phase and after 10 weeks).

Condition Intervention Phase
CKD II-III Drug: Eplerenone Drug: Placebo Phase 1 Phase 2

Study Type: Interventional
Study Design: Primary Purpose: Treatment

Resource links provided by NLM:

Further study details as provided by Marcus Saemann, Medical University of Vienna:

Primary Outcome Measures:
  • Angiotensin levels (pg/ml) of CKD II-III patients with DM II with eplerenone additional to enalapril in comparison to patients who receive a placebo on top of enalapril therapy. [ Time Frame: 1 year ]

Study Start Date: November 2012
Estimated Study Completion Date: December 2016
Estimated Primary Completion Date: December 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Eplerenone
Eplerenone 25-50mg daily additionally to standard ACE-inhibition with enalapril 20mg daily
Drug: Eplerenone
Placebo Comparator: Placebo
Placebo additionally to standard ACE-inhibition with enalapril 20mg daily
Drug: Placebo


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • CKD II to III and diabetes mellitus type 2
  • CKD will be defined according to estimated glomerular filtration rate (eGFR) with the MDRD formula
  • eGFR between 30 and 89 ml/min
  • albumin excretion rates > 300 mg/24 hours (UACR > 300 mg/gram) or > 200 mg/g if already receiving any RAS blockade Patients should be hypertonic stage I or II according to the European guidelines (Chobanian et al. JAMA 2003)

Exclusion Criteria:

  • Age < 18 years
  • UACR > 3500mg/g
  • severe hypertension
  • pregnancy
  • unwilling or inability to sign the informed consent
  • coronary heart disease
  • systolic blood pressure < 130 mmHg
  • additional RAS interfering drugs (ACEis, ARBs, direct renin inhibitors)
  • 25-hydroxy vitamin D levels below 16.6±8.3 pg/ml
  • 1,25-dihydroxy vitamin D 33.1±15.5 pg/ml

Intolerance to eplerenon or an excipient of it:

tablettcore: Lactose-Monohydrat Mikrokristalline Cellulose (E 460) Croscarmellose-sodium (E 468) Hypromellose (E 464) Sodiumdodecylsulfat Talkum (E 553b) Magnesiumstearat (E 470b)


Opadry, yellow:

Hypromellose (E 464) Titandioxid (E 171) Macrogol 400 Polysorbat 80 (E 433) Yellow ironoxide (E 172) Red ironoxide (E 172)

  • Patients with Serumpotassium > 5,0 mmol/l at start of the treatment
  • Patients with severe renal insufficiency (eGFR <30ml/min./1.73 m2)
  • Patients with severe liver insufficiency (Child-Pugh class C)
  • Patients taking potassium saving diuretics, potassium supplements or strong CYP3A4-inhibitors (z. B. Itraconazol, Ketoconazol, Ritonavir, Nelfinavir, Clarithromycin, Telithromycin und Nefazodon)
  Contacts and Locations
Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01832558

Contact: Marcus Saemann, MD 0043/404005593 marcus.saemann@meduniwien.ac.at

Medical University of Vienna Recruiting
Vienna, Austria, 1090
Contact: Marcus Saemann, MD    01/40400/5593    marcus.saemann@meduniwien.ac.at   
Sub-Investigator: Johannes Kovarik, MD         
Sponsors and Collaborators
Medical University of Vienna
  More Information

Responsible Party: Marcus Saemann, Assoc. Prof. Priv.-Doz. Dr.med.univ., Medical University of Vienna
ClinicalTrials.gov Identifier: NCT01832558     History of Changes
Other Study ID Numbers: EudraCT: 2012-002175-34
First Submitted: April 8, 2013
First Posted: April 16, 2013
Last Update Posted: March 16, 2016
Last Verified: March 2016

Additional relevant MeSH terms:
Mineralocorticoid Receptor Antagonists
Hormone Antagonists
Hormones, Hormone Substitutes, and Hormone Antagonists
Physiological Effects of Drugs
Diuretics, Potassium Sparing
Natriuretic Agents