US researchers have reported a single dose of an experimental drug zilebesiran helped lower blood pressure for 6 months.
The team from the University of Chicago, whose findings from the drug’s phase 2 clinical trial were recently presented at the American Heart Association’s Scientific Sessions 2023, found zilebesiran ‘safe and effective in reducing systolic blood pressure in people with mild-to-moderate high blood pressure for up to 6 months with just one injection’.
While high blood pressure is typically treated through medications and lifestyle changes – such as a healthy diet and increased physical activity – previous research had shown many patients don’t adhere to their prescribed medication, often stopping taking the drugs after one year, leaving them open to risks associated with uncontrolled hypertension.
Study co-author Professor George Bakris told medicalnewstoday.com over 70% of patients with hypertension either do not take their medications or do not take them as prescribed; hence ‘we have less than 30% of people with hypertension controlled (in the US), in spite of the fact we have over 100 anti- hypertensive medications for use.’
Zilebesiran is an investigational RNA interference agent targeting angiotensinogen (AGT) – a hormone mainly produced in the liver that helps regulate a person’s blood pressure.
‘Zilebesiran blocks the message within the cell that stimulates production of angiotensinogen,’ Professor Bakris explained. ‘This is the substance that is transformed into angiotensin – a potent agent that causes arteries to constrict and raises blood pressure.’
For the study, his team recruited 400 people with mild-to-moderate high blood pressure, defined a blood pressure of 135-160 mm Hg; all were either untreated for high blood pressure or on stable therapy with up to 2 antihypertensive medications.
Participants received either 150mg, 300mg or 600mg doses once every 6 months, a 300mg dose once every 3 months of zilebesiran or a placebo.
After 6 months, participants who received zilebesiran were significantly more likely to experience 24-hour average systolic blood pressure reductions of 20 mm Hg or more without needing to take additional high blood pressure medications.
Participants taking zilebesiran were also more likely to reach 24-hour average systolic blood pressure measurements of 130 mm Hg or less at 6 months.
Professor Bakris summed up: ‘I was pleasantly surprised the effect lasted 6 months, but based on what I knew about the drug, I expected 3 months. Also, I did not expect the magnitude of the fall to be as great as 14-15 mm Hg, but more like 7-8 mm Hg, which is what the pills deliver. But then again, zilebesiran more effectively blocks the system.’
After reviewing the research, Dr Ian del Conde at Miami Cardiac & Vascular Institute, said ‘this is an exciting study that marks a new era in the treatment of high blood pressure. The idea a chronic condition that is extremely prevalent in all societies in the world and has been clearly shown to increase the risk of premature death can be effectively and safely treated with a single injection administered every 6 months or so is a game changer.’
And Professor Sir Nilesh Samani, medical director at the British Heart Foundation, told medicalnewstoday.com: ‘This study shows that an injection which could be given as little as twice a year is effective at lowering blood pressure.
‘Further work is needed to show it reduces heart attacks and strokes, but if this is the case then this could be a game-changing new treatment for high blood pressure.’
