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Baxdrostat Slashes BP in Resistant Hypertension: BrigHTN
An investigational aldosterone synthase inhibitor could be an effective new treatment to reduce blood pressure in patients with treatment-resistant hypertension, a phase 2 study suggests.
The BrigHTN trial showed systolic blood pressure fell by an average of 20.3 mm Hg, 17.5 mm Hg, and 12.1 mm Hg with baxdrostat 2 mg, 1 mg, and 0.5 mg after 12 weeks follow-up in 248 patients unable to achieve target blood pressure on stable doses of at least three antihypertensive agents, including a diuretic.
After adjustment for the -9.4 mm Hg change observed in the placebo group, there was a statistically significant difference of 11.0 mm Hg in the 2-mg baxdrostat group (P = .0001) and of 8.1 mm Hg in the 1-mg baxdrostat group
(P = .003).
The adjusted change in diastolic blood pressure was significant only for the 2-mg dose (-5.2 mm Hg; P = .004).
Once-daily oral baxdrostat had an acceptable side-effect profile and no patients died.
For at least 20 years, researchers have tried to create a drug that would lower aldosterone levels directly by inhibiting hormone synthesis rather than blocking the mineralocorticoid receptor.
The study, which was stopped early after meeting criteria for overwhelming efficacy, was presented in the final late-breaking science session at the American Heart Association Scientific Sessions 2022 and published simultaneously in the New England Journal of Medicine.
N Engl J Med. Published November 7, 2022. Abstract
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