Firibastat, a new antihypertensive targeting a key metabolic pathway in the brain, reduces blood pressure regardless of patient profile. This is the result of the New-Hope study presented at the congress of the American Heart Association.
According to a new study presented at the American Congress of Cardiology, the AHA, or American Heart Association, firibastat reduces blood pressure in different profiles of hypertensives. The only predictive factor for the decrease in pressure is the level of blood pressure at inclusion.
The result is obtained whether the patient is not treated initially or whether he is treated with one or more antihypertensives. Good news for a condition where nearly half of patients are not on target despite extensive treatment.
A new therapeutic route
Firibastat is a new molecule with a very unique mechanism of action in hypertension, in that it acts on the brain and not on peripheral organs like most other anti-hypertensives.
It is the first inhibitor of aminopeptidases-A and, in doing so, it will block the transformation of angiotensin II into angiotensin III in the brain. All this leads to a reduction in vasopressin release and sympathetic activity, as well as an improvement in the baroreflex response.
A study validating the effectiveness
New-Hope is a phase II study carried out on 218 hypertensive patients with a systolic blood pressure between 145 and 170 mm Hg and a diastolic lower than 105 mm Hg. Several doses of firibastat have been tested, 250 or 500 mg, twice per day.
The BMI of the patients is between 25 and 45 (average BMI = 33) and 50% of them are black or Hispanic, which meets the modern requirements of regulatory authorities, in order to take into account the metabolic differences that are sometimes observed. .
Significant reduction in blood pressure
At 8 weeks, the automated systolic blood pressure had dropped by 9.7 mm Hg (p<0.0001) and the diastolic by 4.3 mm Hg (p<0.0001) compared to the values measured at inclusion. This drop in pressure is obtained on the automated measurement of blood pressure, the most difficult criterion to validate and also the most interesting criterion for patients.
The drop in blood pressure is consistent across all patient subgroups, including black and obese patients. Tolerance is good with side effects mainly of the headache type (4%) and skin reactions (3%). There is no significant change in blood potassium levels
The New-Hope study demonstrates that it is possible to still discover mechanisms of high blood pressure that have not yet been targeted and that blocking them can significantly lower blood pressure with a mechanism that can only be complementary mechanisms targeted by current treatments.
New Hope Study: Interview with Dr. Keith Ferdinand, Professor of Medicine at the Tulane University School of Medicine, New Orleans, USA
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