Sequential Combined Versus Single-Strategy Adrenal Venous Sampling for Primary Aldosteronism(SCOPE)

NCT07298954 | Recruiting DMC

• 1 other identifier: SCOPE PA
• Study Type: interventional
• Target: 456
• Locations: 1 country
• Sites: 1

Brief Summary

This study is a prospective, multicenter, randomized clinical trial aimed to compare the impact of three AVS diagnostic strategies on the clinical outcomes of patients with primary aldosteronism. The strategies include sequential combined AVS (non-ACTH-stimulated followed by ACTH-stimulated AVS), non- ACTH-stimulated AVS alone, and ACTH-stimulated AVS alone. The findings of this study will provide critical evidence for the clinical practice standards of AVS.

Conditions

Primary Aldosteronism

Keywords

Primary Aldosteronism; Adrenal venous sampling; sequential combined AVS; non-ACTH-stimulated; ACTH-stimulated AVS; complete biochemical remission rate

Outcome Measures

Primary Outcomes (1)

• The proportion of complete biochemical remission

  Blood was drawn to measure aldosterone, renin and potassium.According to PASO criteria, outcomes of adrenalectomy for unilateral primary aldosteronism were classified into complete, partial, and absent success, for both clinical and biochemical outcomes.The proportion of complete biochemical remission according to PASO consensus criteria.

  At 6 months of follow-up

Secondary Outcomes (8)

• The proportion of complete clinical remission

  At 6 months of follow-up

• The proportion of complete biochemical response rate

  At 6 months of follow-up

• The proportion of complete clinical response rate

  At 6 months of follow-up

• Comparison of adverse events

  At 6 months of follow-up

• In surgical population, the proportion of complete biochemical remission

  At 6 months of follow-up

Study Arms (3)

sequential combined AVS

EXPERIMENTAL

non-ACTH-stimulated followed by ACTH-stimulated AVS

Diagnostic Test: sequential combined AVS

non-ACTH-stimulated AVS

NO INTERVENTION

non-ACTH-stimulated AVS

ACTH-stimulated AVS

NO INTERVENTION

ACTH-stimulated AVS

Interventions

sequential combined AVS DIAGNOSTIC_TEST

non-ACTH-stimulated followed by ACTH-stimulated AVS

sequential combined AVS

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Fully understand the study process, voluntarily agree to participate, and sign informed consent.
• Diagnosed with primary aldosteronism. # Age 18-70 years with hypertension, any sex.

You may not qualify if:

• Patients for whom AVS can be bypassed: Typical BPA (normal serum potassium and plasma aldosterone concentration (PAC) \< 110 pg/mL, eligible for direct medical therapy); Typical UPA (PAC ≥ 200 pg/mL, plasma renin concentration (PRC) ≤ 5 μIU/mL, spontaneous hypokalemia, unilateral adrenal adenoma ≥ 1 cm with normal contralateral adrenal on CT or 68Ga-Pentixafor PET-CT indicating unilateral functional tumor, eligible for direct surgery);
• Refusal of AVS or surgery, or contraindication to surgery.
• Allergy to ACTH or contrast agents.
• Combined with autonomous cortisol secretion (1 mg overnight dexamethasone suppression test cortisol ≥ 50 nmol/L).
• Early-onset hypertension (\<20 years) with hypokalemia and family history, suggestive of familial hyperaldosteronism or Liddle syndrome.
• Imaging cannot exclude pheochromocytoma or adrenocortical carcinoma (nodule ≥ 4 cm, CT ≥ 20 HU, or MRI suggestive).
• Active malignancy.
• Previous adrenal surgery.
• Chronic glucocorticoid use that cannot be discontinued.
• Adrenal insufficiency requiring hormone replacement.
• Pregnancy or breastfeeding; history of alcohol or substance abuse, or inability to cooperate due to psychiatric disorders.
• NYHA class III-IV heart failure or hospitalization for worsening heart failure in the past 3 months, stroke or acute coronary syndrome in past 3 months, severe anemia (Hb \< 60 g/L), severe liver or renal disease (ALT ≥ 3×upper limit; eGFR \<30 mL/min/1.73 m2 or dialysis), systemic inflammatory response syndrome (SIRS), poorly controlled diabetes (FBG ≥ 13.3 mmol/L), severe obesity (BMI ≥ 35 kg/m2), untreated aneurysm, or other conditions severely interfering with study participation.

Sponsors & Collaborators

• First Affiliated Hospital of Kunming Medical University: collaborator
• The People's Hospital of Chuxiong Yi Autonomous Prefecture: collaborator
• Shumin Yang: lead
• The First Affiliated Hospital of Nanchang University: collaborator

Study Sites (1)

The First Affilated Hospital of Chongqing Medical University

Chongqing, China

RECRUITING

Related Publications (25)

• Monticone S, Burrello J, Tizzani D, Bertello C, Viola A, Buffolo F, Gabetti L, Mengozzi G, Williams TA, Rabbia F, Veglio F, Mulatero P. Prevalence and Clinical Manifestations of Primary Aldosteronism Encountered in Primary Care Practice. J Am Coll Cardiol. 2017 Apr 11;69(14):1811-1820. doi: 10.1016/j.jacc.2017.01.052.

  PMID: 28385310 RESULT

• Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, Ganzaroli C, Giacchetti G, Letizia C, Maccario M, Mallamaci F, Mannelli M, Mattarello MJ, Moretti A, Palumbo G, Parenti G, Porteri E, Semplicini A, Rizzoni D, Rossi E, Boscaro M, Pessina AC, Mantero F; PAPY Study Investigators. A prospective study of the prevalence of primary aldosteronism in 1,125 hypertensive patients. J Am Coll Cardiol. 2006 Dec 5;48(11):2293-300. doi: 10.1016/j.jacc.2006.07.059. Epub 2006 Nov 13.

  PMID: 17161262 RESULT

• Xu Z, Yang J, Hu J, Song Y, He W, Luo T, Cheng Q, Ma L, Luo R, Fuller PJ, Cai J, Li Q, Yang S; Chongqing Primary Aldosteronism Study (CONPASS) Group. Primary Aldosteronism in Patients in China With Recently Detected Hypertension. J Am Coll Cardiol. 2020 Apr 28;75(16):1913-1922. doi: 10.1016/j.jacc.2020.02.052.

  PMID: 32327102 RESULT

• Libianto R, Russell GM, Stowasser M, Gwini SM, Nuttall P, Shen J, Young MJ, Fuller PJ, Yang J. Detecting primary aldosteronism in Australian primary care: a prospective study. Med J Aust. 2022 May 2;216(8):408-412. doi: 10.5694/mja2.51438. Epub 2022 Feb 25.

  PMID: 35218017 RESULT

• Mulatero P, Sechi LA, Williams TA, Lenders JWM, Reincke M, Satoh F, Januszewicz A, Naruse M, Doumas M, Veglio F, Wu VC, Widimsky J. Subtype diagnosis, treatment, complications and outcomes of primary aldosteronism and future direction of research: a position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. J Hypertens. 2020 Oct;38(10):1929-1936. doi: 10.1097/HJH.0000000000002520.

  PMID: 32890265 RESULT

• Hundemer GL, Curhan GC, Yozamp N, Wang M, Vaidya A. Renal Outcomes in Medically and Surgically Treated Primary Aldosteronism. Hypertension. 2018 Sep;72(3):658-666. doi: 10.1161/HYPERTENSIONAHA.118.11568.

  PMID: 29987110 RESULT

• Funder JW, Carey RM, Mantero F, Murad MH, Reincke M, Shibata H, Stowasser M, Young WF Jr. The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2016 May;101(5):1889-916. doi: 10.1210/jc.2015-4061. Epub 2016 Mar 2.

  PMID: 26934393 RESULT

• Song Y, Yang J, Shen H, Ng E, Fuller PJ, Feng Z, Hu J, Ma L, Yang Y, Du Z, Wang Y, Luo T, He W, Li Q, Wu FF, Yang S; represent for the Chongqing Primary Aldosteronism Study (CONPASS) Group. Development and validation of model for sparing adrenal venous sampling in diagnosing unilateral primary aldosteronism. J Hypertens. 2022 Sep 1;40(9):1692-1701. doi: 10.1097/HJH.0000000000003197. Epub 2022 Jul 22.

  PMID: 35881462 RESULT

• Adler GK, Stowasser M, Correa RR, Khan N, Kline G, McGowan MJ, Mulatero P, Murad MH, Touyz RM, Vaidya A, Williams TA, Yang J, Young WF, Zennaro MC, Brito JP. Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2025 Aug 7;110(9):2453-2495. doi: 10.1210/clinem/dgaf284.

  PMID: 40658480 RESULT

• Chee NYN, Abdul-Wahab A, Libianto R, Gwini SM, Doery JCG, Choy KW, Chong W, Lau KK, Lam Q, MacIsaac RJ, Chiang C, Shen J, Young MJ, Fuller PJ, Yang J. Utility of adrenocorticotropic hormone in adrenal vein sampling despite the occurrence of discordant lateralization. Clin Endocrinol (Oxf). 2020 Oct;93(4):394-403. doi: 10.1111/cen.14220. Epub 2020 Jun 15.

  PMID: 32403203 RESULT

• Elliott P, Holmes DT. Adrenal vein sampling: substantial need for technical improvement at regional referral centres. Clin Biochem. 2013 Oct;46(15):1399-404. doi: 10.1016/j.clinbiochem.2013.04.004. Epub 2013 Apr 16.

  PMID: 23603377 RESULT

• Laurent I, Astere M, Zheng F, Chen X, Yang J, Cheng Q, Li Q. Adrenal venous sampling with or without adrenocorticotropic hormone stimulation: A meta-analysis. J Clin Endocrinol Metab. 2018 Nov 6. doi: 10.1210/jc.2018-01324. Online ahead of print.

  PMID: 30403797 RESULT

• Monticone S, Satoh F, Giacchetti G, Viola A, Morimoto R, Kudo M, Iwakura Y, Ono Y, Turchi F, Paci E, Veglio F, Boscaro M, Rainey W, Ito S, Mulatero P. Effect of adrenocorticotropic hormone stimulation during adrenal vein sampling in primary aldosteronism. Hypertension. 2012 Apr;59(4):840-6. doi: 10.1161/HYPERTENSIONAHA.111.189548. Epub 2012 Feb 13.

  PMID: 22331382 RESULT

• Rossi GP, Pitter G, Bernante P, Motta R, Feltrin G, Miotto D. Adrenal vein sampling for primary aldosteronism: the assessment of selectivity and lateralization of aldosterone excess baseline and after adrenocorticotropic hormone (ACTH) stimulation. J Hypertens. 2008 May;26(5):989-97. doi: 10.1097/HJH.0b013e3282f9e66a.

  PMID: 18398342 RESULT

• Rossi GP, Ganzaroli C, Miotto D, De Toni R, Palumbo G, Feltrin GP, Mantero F, Pessina AC. Dynamic testing with high-dose adrenocorticotrophic hormone does not improve lateralization of aldosterone oversecretion in primary aldosteronism patients. J Hypertens. 2006 Feb;24(2):371-9. doi: 10.1097/01.hjh.0000202818.10459.96.

  PMID: 16508586 RESULT

• Seccia TM, Miotto D, De Toni R, Pitter G, Mantero F, Pessina AC, Rossi GP. Adrenocorticotropic hormone stimulation during adrenal vein sampling for identifying surgically curable subtypes of primary aldosteronism: comparison of 3 different protocols. Hypertension. 2009 May;53(5):761-6. doi: 10.1161/HYPERTENSIONAHA.108.128553. Epub 2009 Apr 6.

  PMID: 19349554 RESULT

• Rossitto G, Amar L, Azizi M, Riester A, Reincke M, Degenhart C, Widimsky J, Naruse M, Deinum J, Schultzekool L, Kocjan T, Negro A, Rossi E, Kline G, Tanabe A, Satoh F, Rump LC, Vonend O, Willenberg HS, Fuller P, Yang J, Nian Chee NY, Magill SB, Shafigullina Z, Quinkler M, Oliveras A, Chang CC, Wu VC, Somloova Z, Maiolino G, Barbiero G, Battistel M, Lenzini L, Quaia E, Pessina AC, Rossi GP. Subtyping of Primary Aldosteronism in the AVIS-2 Study: Assessment of Selectivity and Lateralization. J Clin Endocrinol Metab. 2020 Jun 1;105(6):dgz017. doi: 10.1210/clinem/dgz017.

  PMID: 31536622 RESULT

• Takeda Y, Umakoshi H, Takeda Y, Yoneda T, Kurihara I, Katabami T, Ichijo T, Wada N, Yoshimoto T, Ogawa Y, Kawashima J, Sone M, Takahashi K, Watanabe M, Matsuda Y, Kobayashi H, Shibata H, Kamemura K, Otsuki M, Fujii Y, Yamamto K, Ogo A, Yanase T, Suzuki T, Naruse M; JPAS Study Group. Impact of adrenocorticotropic hormone stimulation during adrenal venous sampling on outcomes of primary aldosteronism. J Hypertens. 2019 May;37(5):1077-1082. doi: 10.1097/HJH.0000000000001964.

  PMID: 30601318 RESULT

• Yatabe M, Bokuda K, Yamashita K, Morimoto S, Yatabe J, Seki Y, Watanabe D, Morita S, Sakai S, Ichihara A. Cosyntropin stimulation in adrenal vein sampling improves the judgment of successful adrenal vein catheterization and outcome prediction for primary aldosteronism. Hypertens Res. 2020 Oct;43(10):1105-1112. doi: 10.1038/s41440-020-0445-x. Epub 2020 Apr 30.

  PMID: 32355223 RESULT

• Yozamp N, Hundemer GL, Moussa M, Underhill J, Fudim T, Sacks B, Vaidya A. Adrenocorticotropic Hormone-Stimulated Adrenal Venous Sampling Underestimates Surgically Curable Primary Aldosteronism: A Retrospective Cohort Study and Review of Contemporary Studies. Hypertension. 2021 Jul;78(1):94-103. doi: 10.1161/HYPERTENSIONAHA.121.17248. Epub 2021 May 17.

  PMID: 33993726 RESULT

• Yang S, Du Z, Zhang X, Zhen Q, Shu X, Yang J, Song Y, Yang Y, Li Q, Hu J; Chongqing Primary Aldosteronism Study (CONPASS) Group. Corticotropin Stimulation in Adrenal Venous Sampling for Patients With Primary Aldosteronism: The ADOPA Randomized Clinical Trial. JAMA Netw Open. 2023 Oct 2;6(10):e2338209. doi: 10.1001/jamanetworkopen.2023.38209.

  PMID: 37870836 RESULT

• Preston CA, Yong EXZ, Marginson B, Farrell SG, Sawyer MP, Hashimura H, Derbyshire MM, MacIsaac RJ, Sachithanandan N. Utility of Adrenal Vein Sampling With and Without Ultra-Low Dose ACTH Infusion in the Diagnostic Evaluation of Primary Aldosteronism. Endocrinol Diabetes Metab. 2024 Sep;7(5):e70001. doi: 10.1002/edm2.70001.

  PMID: 39207956 RESULT

• Hu J, Xu T, Shen H, Song Y, Yang J, Zhang A, Ding H, Xing N, Li Z, Qiu L, Ma L, Yang Y, Feng Z, Du Z, He W, Sun Y, Cai J, Li Q, Chen Y, Yang S; Chongqing Primary Aldosteronism Study (CONPASS) Group. Accuracy of Gallium-68 Pentixafor Positron Emission Tomography-Computed Tomography for Subtyping Diagnosis of Primary Aldosteronism. JAMA Netw Open. 2023 Feb 1;6(2):e2255609. doi: 10.1001/jamanetworkopen.2022.55609.

  PMID: 36795418 RESULT

• Williams TA, Lenders JWM, Mulatero P, Burrello J, Rottenkolber M, Adolf C, Satoh F, Amar L, Quinkler M, Deinum J, Beuschlein F, Kitamoto KK, Pham U, Morimoto R, Umakoshi H, Prejbisz A, Kocjan T, Naruse M, Stowasser M, Nishikawa T, Young WF Jr, Gomez-Sanchez CE, Funder JW, Reincke M; Primary Aldosteronism Surgery Outcome (PASO) investigators. Outcomes after adrenalectomy for unilateral primary aldosteronism: an international consensus on outcome measures and analysis of remission rates in an international cohort. Lancet Diabetes Endocrinol. 2017 Sep;5(9):689-699. doi: 10.1016/S2213-8587(17)30135-3. Epub 2017 May 30.

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• Yang J, Burrello J, Goi J, Reincke M, Adolf C, Asbach E, Brudgam D, Li Q, Song Y, Hu J, Yang S, Satoh F, Ono Y, Libianto R, Stowasser M, Li N, Zhu Q, Hong N, Nayak D, Puar TH, Wu VC, Vaidya A, Araujo-Castro M, Kocjan T, O'Toole SM, Hundemer GL, Ragnarsson O, Lacroix A, Larose S, Nakai K, Nishikawa T, Ladygina D, Turcu AF, Sholinyan J, Fardella CE, Uslar T, Quinkler M, Mulatero P, Pintus G, Rossi GP, Hahner S, Amar L, Drake WM, Varsani C, Brown MJ, Wu X, Deinum J, Freel EM, Kline G, Naruse M, Prejbisz A, Young WF Jr, Williams TA, Fuller PJ. Outcomes after medical treatment for primary aldosteronism: an international consensus and analysis of treatment response in an international cohort. Lancet Diabetes Endocrinol. 2025 Feb;13(2):119-133. doi: 10.1016/S2213-8587(24)00308-5. Epub 2025 Jan 14.

  PMID: 39824204 RESULT

MeSH Terms

Conditions

Hyperaldosteronism

Condition Hierarchy (Ancestors)

Adrenocortical Hyperfunction; Adrenal Gland Diseases; Endocrine System Diseases

Study Officials

• Shumin Yang

  the Chongqing Primary Aldosteronism Study (CONPASS) Group

  STUDY CHAIR

Central Study Contacts

Shumin Yang

CONTACT

+86 023-89011552; ysm@hospital.cqmu.edu.cn

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Primary investigator

Study Record Dates

• First Submitted: December 10, 2025
• First Posted: December 23, 2025
• Study Start: December 25, 2025
• Primary Completion (Estimated): December 31, 2027
• Study Completion (Estimated): December 31, 2028
• Last Updated: December 24, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)