Spironolactone Metabolites in TOPCAT — New Insights into Regional Variation

Authors: Simon de Denus, Eileen O’Meara, Akshay S. Desai, Brian Claggett, Eldrin F. Lewis, Grégoire Leclair, Martin Jutras, Joël Lavoie, Scott D. Solomon, Bertram Pitt, Marc A. Pfeffer, Jean L. Rouleau - New England Journal of Medicine, NEJM 2017 cited by 267

In a subgroup of TOPCAT participants assigned to spironolactone, the spironolactone metabolite canrenone was measured to assess adherence. Canrenone levels were undetectable in 30% of participants from Russia, as compared with only 3% from the United States and Canada.