Zilebesiran Shows Potential in Lowering Blood Pressure in High-Risk Hypertensive Patients

Recent clinical trial results reveal that a single subcutaneous dose of zilebesiran, an investigational RNA interference therapy, has the potential to reduce blood pressure in patients with uncontrolled hypertension and a high risk of cardiovascular disease. The phase II KARDIA-3 trial, conducted across five countries, focused on adult patients with established cardiovascular conditions or high risk factors, who were already on multiple antihypertensive medications but still had elevated blood pressure readings. The study analyzed the effects of zilebesiran at doses of 300 mg and 600 mg compared to placebo, observing changes over a three- to six-month period.

Results indicated a trend toward lower systolic blood pressure (SBP), with patients receiving 300 mg showing a mean reduction of 5 mmHg at three months, although this did not achieve statistical significance. Similar patterns were observed at six months, especially in 24-hour ambulatory blood pressure monitoring, where zilebesiran at both doses lowered SBP by approximately 5 to 7 mmHg compared to placebo. A notable post-hoc analysis showed greater blood pressure reduction in patients already on diuretics and with higher baseline SBP.

Safety assessments demonstrated that most adverse events were mild or moderate and transient, with serious adverse events being rare and comparable across groups. The findings suggest that while the primary endpoints did not reach statistical significance, the data support further investigation of zilebesiran in larger, more definitive phase III trials. As Dr. Neha Pagidipati emphasized, this study provides valuable insights that will inform future research aimed at improving hypertension management and cardiovascular outcomes.

High blood pressure remains a significant contributor to global mortality, and new treatments like zilebesiran could offer more effective options, especially for patients who struggle with achieving blood pressure control using current therapies.