Biannual Injection of zilebesiran Shows Promising Blood Pressure Control In clinical trial: JAMA

Results from a clinical trial led by researchers from Queen Mary University of London, published today in JAMA, show that giving people with high blood pressure an injection every six months can lead to a meaningful, sustained reduction in their blood pressure.

The global trial, KARDIA-2, involved 663 people with high blood pressure whose condition wasn’t being well managed with their standard treatment.

In the trial, patients were given an injection of a new medication zilebesiran, alongside their standard blood pressure treatments. Researchers found that giving patients zilebesiran alongside their standard medication was better at reducing their blood pressure levels than standard medication alone.

The results could have a big positive impact for those with high-blood pressure, which affects around 1 in 3 adults in the UK and, if left untreated, increases the risk of cardiovascular events such as heart attacks, strokes and even death.

Dr Manish Saxena, Clinical Co-Director of the William Harvey Clinical Research Centre at Queen Mary University of London and a hypertension specialist at Barts Health NHS Trust was the lead investigator for the study in the UK and senior author on the new publication. Speaking on the results, he said:

"Hypertension is a global health concern as blood pressure control rates remain poor and is a leading cause of heart attacks and strokes. This study demonstrates the efficacy and safety of zilebesiran, when added to commonly used first line blood pressure lowering drugs. The novelty of this treatment is its long duration; giving just one injection every six months could help millions of patients to better manage their condition.”

Zilebesiran is an investigational therapeutic that uses RNA interference technology. It blocks the production of a specific protein in the liver (angiotensinogen), helping blood vessels to relax and lowering blood pressure. The injection is given under the skin.

The next steps for zilebesiran involve another Phase 2 study, KARDIA-3, to see if this treatment has potential to be used to treat people with high blood pressure and established cardiovascular disease, or those at high risk of cardiovascular disease.

Later this year, the sponsor plans to enrol patients in a big global outcomes study to understand its effect on reducing cardiovascular events, strokes and cardiovascular death.

Reference:

Desai AS, Karns AD, Badariene J, et al. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 Randomized Clinical Trial. JAMA. Published online May 28, 2025. doi:10.1001/jama.2025.6681.