A new study led by researchers from Queen Mary University of London and Barts Health NHS Trust shows a novel drug called Zilebesiran given as injection under the skin once every three or six months, successfully reduces high blood pressure (hypertension).
The trial, conducted over two years, gave 394 patients one of five treatment options. These were 150mg Zilebesiran (the injection-based medication) every 6 months, 300mg Zilebesiran every 6 months, 300mg Zilebesiran every 3 months, 600mg Zilebesiran every 6 months, or a placebo. All the patients either had untreated hypertension or had a wash out of their current blood pressure medication .
The results showed that by the third month, Zilebesiran was successfully reducing hypertension. Mean 24 hrs systolic blood pressure was reduced by 14.1 mmHg with the 150 mg dose, 16.7 mmHg with the 300 mg dose, and 15.7 mmHg with the 600 mg dose. There was significant reductions in mean blood pressure not just during the day time but also during night time period.
Those diagnosed with high blood pressure typically take tablets once or twice a day to control the condition, with ACE inhibitors being the most common medication prescribed.
However, Zilebesiran could ultimately change how high blood pressure is treated for adults, reduce burden on the NHS, and offer a more convenient solution for patients.
The study drug was well tolerated with very few patients having transient local injection site reactions or transient rise in their serum potassium levels that did not need further intervention.
The results were presented at the American Heart Association Congress and will be published in a scientific journal in coming weeks. The study is funded by Alnylam Pharmaceuticals, with Queen Mary University of London and Barts Health NHS Trust serving as the lead sites for the trial.
Dr Manish Saxena, study lead from Queen Mary University of London and Hypertension Specialist at Barts Health NHS Trust said: “Sustained blood pressure reduction of this magnitude could translate into significant reduction in the amount of heart attacks, strokes and heart failure – which are all linked cardiovascular events. This exciting new treatment has the potential to improve blood pressure control and with 6-monthly dosing, could also help reduce burden on the NHS. Hypertension is the most important modifiable risk factor for cardiovascular diseases with almost 33% adults in the UK having hypertension, so treating it is incredibly important.”
Professor George L. Bakris, M.D., Board-Certified Hypertension Specialist and Director of the American Heart Association Comprehensive Hypertension Center, University of Chicago Medicine, said: “These KARDIA-1 results show that in a diverse group of patients with mild-to-moderate hypertension, Zilebesiran can achieve clinically significant reductions in systolic blood pressure and tonic blood pressure control after one dose. I continue to be encouraged and optimistic about the potential that Zilebesiran has to become a transformative therapy to lower cardiovascular risk in patients with hypertension, an area where new and innovative therapies are desperately needed.”
Zilebesiran works by inhibiting the production of a gene called AGT, preventing constriction of blood vessels which may help reduce elevated blood pressure.
Key risk factors for hypertension include being overweight, a poor diet with excess salt and not enough fruit and vegetables, along with smoking and a lack of exercise.