Idorsia’s aprocitentan improved key prognostic indicators in patients with difficult-to-control hypertension

Core Insights - Idorsia Ltd announced the publication of a new analysis from the Phase 3 PRECISION study, highlighting the effects of aprocitentan on blood pressure variables in resistant hypertension patients [1][7]. Group 1: Aprocitentan's Efficacy - Aprocitentan significantly lowered 24-hour blood pressure in patients with resistant hypertension, especially at night, which is a critical indicator of long-term outcomes [2][12]. - The analysis showed that aprocitentan improved multiple characteristics linked to poor clinical outcomes, including blood pressure load reduction and normalization of night-time dipping patterns [2][12]. - Aprocitentan was effective in patients with increased arterial stiffness and salt sensitivity, indicating its broad applicability [2][12]. Group 2: Clinical Implications - Experts believe that aprocitentan could reduce cardiovascular events and improve long-term outcomes for patients with resistant hypertension [3][4]. - The drug addresses a significant medical need for patients with difficult-to-control hypertension, without the risks associated with hyperkalemia or worsening renal function [5][4]. - Aprocitentan is now included in the American College of Cardiology and American Heart Association guidelines for managing high blood pressure [8]. Group 3: Study Design and Findings - The PRECISION study was a multicenter, randomized, double-blind trial involving 730 patients, assessing the efficacy of aprocitentan against placebo [9][10]. - Key findings included a significant reduction in office systolic blood pressure (SBP) and diastolic blood pressure (DBP) at 4 weeks, with differences of -15.3 mmHg and -15.2 mmHg for aprocitentan doses compared to placebo [11]. - Aprocitentan treatment led to a higher proportion of patients normalizing their nocturnal blood pressure fall, a positive prognostic indicator [12][14]. Group 4: Safety Profile - Treatment-emergent adverse events were reported in 27.6% and 36.7% of patients treated with aprocitentan, with fluid retention being the most common side effect [15]. - Fluid retention was generally mild to moderate and manageable with current clinical practices [15]. Group 5: Market Context - Approximately 1.4 billion people globally live with hypertension, making it a leading health challenge [5]. - In the US, about 50% of patients with hypertension on multiple treatments do not achieve blood pressure control, highlighting the need for effective therapies like aprocitentan [5].