New Dual Endothelin Receptor Antagonist Aprocitentan in Hypertension: A Systematic Review and Meta-Analysis

Mahfooz, Kamran; Najeed, Syed; Tun, Han; Khamosh, Madina; Grewal, Daisy; Hussain, Aftab M.; Ong, Kenneth; Dharmarajan, Lekshmi; Vasavada, Advait

doi:10.1016/j.cpcardiol.2023.101686

Cited by 3 publications

(1 citation statement)

References 30 publications

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“…The clinical effectiveness and safety of aprocitentan in hypertension has been tested in one dose-finding study [ 47 ] and in one phase 3 trial [ 48 ], both showing positive results in terms of systolic/diastolic BP reduction with good tolerability and safety profile [ 49 ]. It should be noted, however, that both these studies adopted unattended office systolic/diastolic BP measurements for efficacy and safety assessments; this may at least, in part, contribute to explain the high rate of screening failure reported in both studies [ 47 , 48 ].…”

Section: Methodsmentioning

confidence: 99%

Systematic Review Article: New Drug Strategies for Treating Resistant Hypertension—the Importance of a Mechanistic, Personalized Approach

Nardoianni,

Pala,

Scoccia

et al. 2024

High Blood Press Cardiovasc Prev

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Resistant hypertension (RHT) is characterized by persistently high blood pressure (BP) levels above the widely recommended therapeutic targets of less than 140/90 mmHg office BP, despite life-style measures and optimal medical therapies, including at least three antihypertensive drug classes at maximum tolerated dose (one should be a diuretic). This condition is strongly related to hypertension-mediated organ damage and, mostly, high risk of hospitalization due to hypertension emergencies or acute cardiovascular events. Hypertension guidelines proposed a triple combination therapy based on renin angiotensin system blocking agent, a thiazide or thiazide-like diuretic, and a dihydropyridinic calcium-channel blocker, to almost all patients with RHT, who should also receive either a beta-blocker or a mineralocorticoid receptor antagonist, or both, depending on concomitant conditions and contraindications. Several other drugs may be attempted, when elevated BP levels persist in these RHT patients, although their added efficacy in lowering BP levels on top of optimal medical therapy is uncertain. Also, renal denervation has demonstrated to be a valid therapeutic alternative in RHT patients. More recently, novel drug classes and molecules have been tested in phase 2 randomised controlled clinical trials in patients with RHT on top of optimal medical therapy with at least 2–3 antihypertensive drugs. These novel drugs, which are orally administered and are able to antagonize different pathophysiological pathways, are represented by non-steroid mineralocorticorticoid receptor antagonists, selective aldosterone synthase inhibitors, and dual endothelin receptor antagonists, all of which have proven to reduce seated office and 24-h ambulatory systolic/diastolic BP levels. The main findings of randomized clinical trials performed with these drugs as well as their potential indications for the clinical management of RHT patients are summarised in this systematic review article. Supplementary Information The online version contains supplementary material available at 10.1007/s40292-024-00634-4.

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Section: Methodsmentioning

confidence: 99%

Systematic Review Article: New Drug Strategies for Treating Resistant Hypertension—the Importance of a Mechanistic, Personalized Approach

Nardoianni,

Pala,

Scoccia

et al. 2024

High Blood Press Cardiovasc Prev

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Possibilities of dapagliflozin-induced cardioprotection on doxorubicin + cyclophosphamide mode of chemotherapy-induced cardiomyopathy

Avagimyan,

Sheibani,

Pogosova

et al. 2023

International Journal of Cardiology

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Non-Haemodynamic Mechanisms Underlying Hypertension-Associated Damage in Target Kidney Components

Russo¹,

Bussalino

Macciò

et al. 2023

IJMS

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Arterial hypertension (AH) is a global challenge that greatly impacts cardiovascular morbidity and mortality worldwide. AH is a major risk factor for the development and progression of kidney disease. Several antihypertensive treatment options are already available to counteract the progression of kidney disease. Despite the implementation of the clinical use of renin–angiotensin aldosterone system (RAAS) inhibitors, gliflozins, endothelin receptor antagonists, and their combination, the kidney damage associated with AH is far from being resolved. Fortunately, recent studies on the molecular mechanisms of AH-induced kidney damage have identified novel potential therapeutic targets. Several pathophysiologic pathways have been shown to play a key role in AH-induced kidney damage, including inappropriate tissue activation of the RAAS and immunity system, leading to oxidative stress and inflammation. Moreover, the intracellular effects of increased uric acid and cell phenotype transition showed their link with changes in kidney structure in the early phase of AH. Emerging therapies targeting novel disease mechanisms could provide powerful approaches for hypertensive nephropathy management in the future. In this review, we would like to focus on the interactions of pathways linking the molecular consequences of AH to kidney damage, suggesting how old and new therapies could aim to protect the kidney.

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New Dual Endothelin Receptor Antagonist Aprocitentan in Hypertension: A Systematic Review and Meta-Analysis

Cited by 3 publications

References 30 publications

Systematic Review Article: New Drug Strategies for Treating Resistant Hypertension—the Importance of a Mechanistic, Personalized Approach

Systematic Review Article: New Drug Strategies for Treating Resistant Hypertension—the Importance of a Mechanistic, Personalized Approach

Possibilities of dapagliflozin-induced cardioprotection on doxorubicin + cyclophosphamide mode of chemotherapy-induced cardiomyopathy

Non-Haemodynamic Mechanisms Underlying Hypertension-Associated Damage in Target Kidney Components

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