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Lorundrostat Effective for Lowering BP in Uncontrolled Hypertension

Changes in office systolic BP of −14.1, −13.2, −6.9, and −4.1 mm Hg seen with 100, 50, 12.5 mg once daily of lorundrostat and placebo

By Elana Gotkine HealthDay Reporter

FRIDAY, Sept. 15, 2023 (HealthDay News) — The aldosterone synthase inhibitor lorundrostat is effective for lowering blood pressure among individuals with uncontrolled hypertension, according to a study published online Sept. 10 in the Journal of the American Medical Association to coincide with the American Heart Association Hypertension 2023 Scientific Sessions, held from Sept. 7 to 10 in Boston.

Luke J. Laffin, M.D., from the Cleveland Clinic Foundation, and colleagues compared the safety and efficacy of lorundrostat with placebo in a randomized trial among adults with uncontrolled hypertension taking two or more antihypertensive medications. An initial cohort of 163 participants with suppressed plasma renin (plasma renin activity [PRA] ≤1.0 ng/mL/h) and elevated plasma aldosterone (≥1.0 ng/dL) were enrolled and randomly assigned to placebo or one of five doses of lorundrostat; 37 participants with PRA greater than 1.0 ng/mL/h were subsequently enrolled and randomly assigned to placebo or lorundrostat 100 mg once daily.

The researchers observed changes in office systolic blood pressure of −14.1, −13.2, −6.9, and −4.1 mm Hg with 100, 50, and 12.5 mg once daily of lorundrostat and placebo, respectively, following eight weeks of treatment in participants with suppressed PRA. In individuals receiving twice-daily doses of 25 and 12.5 mg of lorundrostat, observed reductions in systolic blood pressure were −10.1 and −13.8 mm Hg, respectively. The least-squares mean difference in systolic blood pressure between placebo and treatment was −9.6 and −7.8 mm Hg, respectively, for the 50- and 100-mg once-daily dose. Systolic blood pressure decreased by 11.4 mm Hg among participants without suppressed PRA receiving 100 mg once-daily lorundrostat, which was similar to the blood pressure reduction with the same dose among those with suppressed PRA.

“The trial results support further study of lorundrostat as a treatment for uncontrolled hypertension,” the authors write.

Several authors disclosed ties to biopharmaceutical companies, including Mineralys Therapeutics, which manufactures lorundrostat and funded the trial.

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