A new phase 2b study has found that lorundrostat, an investigational aldosterone synthase inhibitor, effectively lowers blood pressure for adults with resistant hypertension. The study, known as ADVANCE-HTN, involved 285 participants who were randomly assigned to receive either 50mg of lorundrostat daily or placebo for 12 weeks.
The results showed that the lorundrostat group had a mean systolic blood pressure (BP) decrease of 15.4mmHg compared to the placebo group, which experienced a mean BP decrease of 7.4mmHg. Notably, the dose-escalation strategy from 50mg to 100mg did not lead to further lowering of BP.
The study found that patients in the lorundrostat group were more likely to achieve controlled blood pressure, with an odds ratio of 3.3 compared to the placebo group. However, researchers observed a higher incidence of hyperkalemia in both groups.
According to Dr. Luke J. Laffin, co-director of the Center for Blood Pressure Disorders at Cleveland Clinic, these findings suggest that aldosterone synthase inhibitors could be an effective medicine in lowering blood pressure in the future. The study’s results are slated for upcoming publication in The New England Journal of Medicine and will contribute to the wealth of evidence for regulatory approval of lorundrostat.
The ADVANCE-HTN trial builds on previous studies, including the Target-HTN trial, which demonstrated that lorundrostat was associated with clinically significant reductions in automated office BP for people with uncontrolled hypertension. A pivotal phase 3 trial of lorundrostat has recently completed but has not yet been peer-reviewed.
Source: https://www.healio.com/news/cardiology/20250330/novel-agent-targeting-aldosterone-lowers-blood-pressure-for-adults-with-resistant-hypertension