Aprocitentan effective for BP lowering in patients with CKD and resistant hypertension

The researchers assessed reductions in ambulatory BP monitoring (ABPM), office SBP, and UACR following the double-blind treatment phase (Week 4), after 32-week single-blind APRO 25mg treatment (Week 36), and after 4 weeks of randomized withdrawal (Week 40).

Based on the study, the researchers reported the following findings:

• Both doses of APRO resulted in a more pronounced BP reduction from baseline to week 4 compared to PBO. This was confirmed by ABPM.
• At Week 4, edema or fluid retention occurred in 18% and 24% of patients receiving APRO 12.5mg and 25mg, respectively, vs 2% with PBO; this rate was 34% in subjects exposed to APRO 25 mg during the trial.
• 55% of them were treated with diuretics (90% loop); 2 discontinued treatment due to this event.
• Five patients receiving APRO 25mg and 1 receiving a placebo had heart failure leading to hospitalization; all but one had a history of heart disease.

The findings support the potential use of aprocitentan in patients with BP that remains elevated despite treatment with three established antihypertensive drug classes and with stage 3 CKD with an eGFR of 30-59 mL/min per 1.73 m2 if approved for U.S. marketing in 2024.

"This is a key group of patients because "CKD is the most common comorbidity in patients with resistant hypertension," the researchers concluded.

Reference:

ABSTRACT: FR-OR96 Effects of Aprocitentan for Blood Pressure Lowering and Proteinuria in Patients with CKD and Resistant Hypertension