Endothelin Receptor Antagonists for the Treatment of Hypertension: Recent Data from Clinical Trials and Implementation Approach

Figures

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  Fig. 1. Effects on 24-h ambulatory BP. Changes in ambulatory BP in response to placebo (blue), aprocitentan 12.5 mg (yellow), and aprocitentan 25 mg (red lines and bars) after the 4-week double blind phase (Part 1) and after double-blind withdrawal (Part 3). 24-h profiles (upper panels) demonstrate BP reduction with both doses of aprocitentan compared to placebo across the 24-h period. Absolute BP changes depicted in the lower panels demonstrate a significant dose dependent effect, most pronounced during night-time (lower left panel). After re-randomization to placebo or continued aprocitentan 25 mg BP rose significantly in those receiving placebo, whereas BP was unchanged in those maintained on aprocitentan 25 mg (lower right panel). (Reprinted from: Schlaich MP, et al. Lancet 2022;400:1927–37, with permission from Elsevier) [48]

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  Fig. 2. Subgroup analysis and effects on urinary albumin excretion (UACR). Subgroup analysis revealed that aprocitentan at each dose seems particularly effective in patients above the age of 75 years, those with UACR > 300 mg/g, and in patients with an eGFR of < 60 ml/min/1.73 m.2 (Forrest plot left panel). The impact on UACR is summarized in the right panel demonstrating significant and clinically meaningful reduction in UACR with both doses after the double-blind phase. In the single-blind phase the 30% reduction in UACR was maintained. After re-randomization UACR rose in those on placebo, but remined unchanged in those on continued aprocitentan 25 mg. (Reprinted from: Schlaich MP, et al. Lancet 2022;400:1927–37, with permission from Elsevier) [48]