Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Comparison of Efficacy of Losartan/Spironolactone and Losartan/Enalapril on Urinary Albumin Excretion, Estimated Glomerular Filtration Rate, and Blood Pressure in Patients With Type 2 Diabetes Nephropathy
Brief Summary: The detrimental effects of aldostrone are not adequately arrested by the use of angiotensin converting enzyme (ACE), angiotensin II receptor blocker (ARB) or a combination of both. Recent evidence has provided robust evidence that aldostrone escape plays an important role in this regard. It is believed that aldostrone escape occurs quite commonly with reports indicating prevalence rates as high as 22% with ARBs and 40% with ACE inhibitors. In a trial of patients with diabetes and hypertension it was shown that treatment of aldostrone escape with spironolactone 25 mg daily for three months significantly reduces proteinuria. A number of other trials have similarly observed that addition of spironolactone to an ACE inhibitor based regimen provides additional benefits on proteinuria reduction, blood pressure control, and prevention of glomerular filtration rate (GFR) decline. Most of the available trials in this regard are of short duration (e.g. three months), and have added spironolactone to an ACE or ACE+ARB based regimen (the so-called triple blockade). Currently, evidence evaluating efficacy of a combined ARB+spironolactone regimen compared with conventional double RAS blockade (i.e. ACE+ARB) is lacking. Hence, this randomized open label trial was initiated to determine the effects of addition of spironolactone 25 mg daily to losartan over a period of 18 months.


Options:
A: Arm Label: 1; Type: ACTIVE_COMPARATOR; Interventions: Drug: Irbesartan | Arm Label: 2; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo | Intervention Type: DRUG; Name: Irbesartan; Assigned to Arm(s): 1 | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): 2
B: Arm Label: ACE/ARB; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Spironolactone/ARB; Type: ACTIVE_COMPARATOR; Interventions: Drug: spironolacone 25 mg tablets added to losartan | Intervention Type: DRUG; Name: spironolacone 25 mg tablets added to losartan; Assigned to Arm(s): Spironolactone/ARB
C: Arm Label: Spironolactone; Type: ACTIVE_COMPARATOR; Interventions: Drug: Spironolactone | Arm Label: Placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo | Intervention Type: DRUG; Name: Spironolactone; Assigned to Arm(s): Spironolactone | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Placebo
D: Arm Label: Arm 1; Type: EXPERIMENTAL; Interventions: Drug: BAY94-8862 | Arm Label: Arm 2; Type: EXPERIMENTAL; Interventions: Drug: BAY94-8862 | Arm Label: Arm 3; Type: EXPERIMENTAL; Interventions: Drug: BAY94-8862 | Arm Label: Arm 4; Type: EXPERIMENTAL; Interventions: Drug: BAY94-8862 | Arm Label: Arm 5; Type: PLACEBO_COMPARATOR; Interventions: Drug: Placebo | Arm Label: Arm 6; Type: ACTIVE_COMPARATOR; Interventions: Drug: Spironolactone | Intervention Type: DRUG; Name: BAY94-8862; Assigned to Arm(s): Arm 1 | Intervention Type: DRUG; Name: BAY94-8862; Assigned to Arm(s): Arm 2 | Intervention Type: DRUG; Name: BAY94-8862; Assigned to Arm(s): Arm 3 | Intervention Type: DRUG; Name: BAY94-8862; Assigned to Arm(s): Arm 4 | Intervention Type: DRUG; Name: Placebo; Assigned to Arm(s): Arm 5 | Intervention Type: DRUG; Name: Spironolactone; Assigned to Arm(s): Arm 6

Answer: B