Attempts to develop new drugs for hypertension

It will be difficult to replace existing drugs

“It will be able to fill the gaps in existing drugs”

Interest in the development status of Baxdrostat/Aprocitentan/Firibastat

Opinions were raised that it would be difficult for candidates under development as new drugs for hypertension, such as Baxdrostat, Aprocitentan, and Firibastat, to replace existing drugs.

 

It is expected that it will fill the unmet demand rather than take the place of the prescribed treatment.

 

Choi Ung-gil, professor at Konkuk University Chungju Hospital, is giving a presentation.

 

(photo by Dailypharm)

Professor Woong-Gil Choi of Chungbuk National University Hospital held a hypertension drug treatment update session at the '2023 Korean Society of Hypertension Spring Conference' held at COEX in Daegu on the 20th and said, "Major hypertension drug candidates are existing drugs rather than replacing drugs already prescribed in clinical settings.

 

It will be a drug that can help the unfilled part.” The reason why the development of a new antihypertensive drug is needed is that it is a method to treat treatment-resistant hypertension.

 

Professor Woong-Gil Choi explained, "Although the treatment control rate of hypertension has improved a lot, there is no further development after exceeding 70%." According to Professor Choi, major antihypertensive drug candidates include Baxdrostat, Aprocitentan, and Firibastat.

 

Baxdrostat is a candidate substance secured by AstraZeneca, a global pharmaceutical company when it acquired CinCor Pharma, a US bio company.

 

It is a new drug candidate for hypertension in the class of aldosterone synthase inhibitors (ASI).

 

The efficacy of Baxdrostat in lowering blood pressure was confirmed in phase 2 clinical trial (BrigHTN) conducted on patients with treatment-resistant hypertension.

 

In phase 2 clinical trial (HALO) conducted for uncontrolled hypertension patients taking up to two blood pressure medications, statistical significance was not achieved in the primary endpoint, but systolic blood pressure was reduced in subgroup analysis.

 

Phase 3 clinical trials are expected to begin at the end of this year.

 

Professor Choi said, “Baxdrostat appears to be relatively beneficial for hypertensive hypertension,” and “it is expected to give benefits to patients with primary aldosterone and metabolic syndrome.” Aprocitentan is a new drug candidate for hypertension being jointly developed by global pharmaceutical company Janssen and Swiss bio company Idorsia.

 

It is an endothelin receptor antagonist.

 

Applications for product approval were submitted to the FDA and EMA in December of last year and January of this year, respectively.

 

Clinical data of Baxdrostat (Photo by Dailypharm)

Aprocitentan has been confirmed to have a significant blood pressure-lowering effect in patients whose hypertension is not well controlled despite taking three or more existing treatments in phase 3 clinical trials (PRECISION).

 

Professor Choi explained, "Although Aprocitentan has a stronger blood pressure lowering effect when used with other drugs, care should be taken about the fact that edema occurred after using the drug compared to placebo." Firibastat is a candidate material being developed by Quantum Genomics, a French biotech company.

 

Firibastat is a candidate in the class of brain aminopeptidase A inhibitors.

 

It is a mechanism that suppresses the production of angiotensin 3 in the brain's renin-angiotensin system (Brain RAS).

 

Firibastat's efficacy with statistical significance was confirmed until the phase 2 clinical trial was conducted for patients with treatment-resistant hypertension.

 

Afterward, it failed to achieve the primary evaluation index in phase 3 clinical trial (FRESH).

 

Quantum Genomics is revising its development strategy to find new indications after the early termination of clinical trials.

 

Professor Choi predicted, “There are still many cases of treatment-resistant hypertension, but if the development of a new drug for hypertension is successful, it will be possible to increase the treatment effect by adding it to existing drugs.”