Esaxerenone shows promise in hypertensive patients with kidney dysfunction

Esaxerenone, a mineralocorticoid receptor blocker, effectively and safely controls blood pressure in hypertensive patients with moderate kidney dysfunction, a recent study has found.

Conducting two multicentre, open-label, nonrandomized dose escalation studies, the researchers enrolled 33 patients who were given esaxerenone as a monotherapy, and 58 who received the drug as an add-on to a renin-angiotensin system inhibitor. The study lasted for 12 weeks, after which the primary endpoint of changes in sitting systolic (SBP)/diastolic (DBP) blood pressure were assessed.

The monotherapy group saw a mean SBP/DBP change from baseline of –18.5/–8.8 mm Hg, representing a significant decline (p<0.001). Similarly, the mean change value in the add-on group was –17.8/–8.1 mm Hg, which also reached statistical significance (p<0.001).

In both groups, esaxerenone was initiated at a daily dose of 1.25 mg before it was uptitrated to 2.5 mg/day and eventually to 5 mg/day. Across all doses, the researchers observed substantial decreases in BP in both groups. At the end of the study, 63.6 percent and 48.3 percent of the monotherapy and add-on arms achieved the target BP of <140/90 mm Hg.

Additionally, both monotherapy and add-on arms saw a significant decline from baseline in the urine albumin-to-creatine ratio.

Adverse events were common, developing in 63.6 percent and 60.3 percent of participants in the monotherapy and add-on groups, respectively. Drug-related and treatment-emergent events occurred in 24.2 percent and 29.3 percent in the respective groups. There were no serious adverse events or deaths in either group, though three patients eventually discontinued due to side effects.