Evaluating phase II results of Baxdrostat, an aldosterone synthase inhibitor for hypertension

Expert Opin Investig Drugs. 2023 Jul-Dec;32(11):985-995. doi: 10.1080/13543784.2023.2276755. Epub 2023 Nov 24.

Abstract

Introduction: Hypertension, a global health concern, poses a significant risk for other cardiovascular diseases. While lifestyle modifications and interventions like the Dietary Approaches to Stop Hypertension (DASH) diet offer some respite, their maintenance can be challenging. Recently, the spotlight has turned toward the renin-angiotensin-aldosterone system, a crucial player in the pathophysiology of hypertension. Contrary to other drugs, Baxdrostat, an innovative aldosterone synthase inhibitor (ASI), targets aldosterone synthesis, mitigating negative systemic effects.

Areas covered: Baxdrostat showcases rapid absorption, high oral bioavailability, and significant selectivity for aldosterone synthase which presents a proactive approach to hypertension management by reducing aldosterone levels. Early trials have demonstrated its potential in lowering blood pressure in resistant hypertension cases. Current clinical trials are also exploring its application in primary aldosteronism and chronic kidney disease, with preliminary findings indicating its promise as a novel antihypertensive agent. This article encapsulates the current state of knowledge regarding Baxdrostat, encompassing its uses, ongoing clinical trials, and potential future clinical applications.

Expert opinion: Future research endeavors will play a pivotal role in unveiling the effectiveness and safety profile of this novel medication. Thus, positioning the baxdrostat as a valuable addition to the armamentarium of antihypertensive agents, especially for patients with complex, multifactorial hypertensive conditions.

Keywords: Baxdrostat; CYP11B2; aldosterone synthase inhibitors; essential hypertension; primary hyperaldosteronism; treatment-resistant hypertension.

Publication types

  • Review

MeSH terms

  • Aldosterone / pharmacology
  • Aldosterone / therapeutic use
  • Antihypertensive Agents / adverse effects
  • Clinical Trials, Phase II as Topic
  • Cytochrome P-450 CYP11B2 / pharmacology
  • Enzyme Inhibitors / pharmacology
  • Humans
  • Hyperaldosteronism* / drug therapy
  • Hypertension* / drug therapy
  • Mineralocorticoid Receptor Antagonists / pharmacology
  • Renin / pharmacology
  • Renin / therapeutic use
  • Renin-Angiotensin System

Substances

  • Aldosterone
  • Cytochrome P-450 CYP11B2
  • Antihypertensive Agents
  • Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists
  • Renin