抗性高血压的新试验:混合的祝福故事
Carmine Zoccali1, Francesca Mallamaci2,3, Luca De Nicola4
1Renal Research Institute, New York, NY, USA.
Clinical kidney journal
|January 8, 2024
概括
对抗性高血压的新疗法显示出不同的结果. 虽然阿布罗西坦和巴克斯德罗斯塔特等一些药物具有潜在的益处,但其他药物 (如费里巴斯塔特) 尚未被证明是有效的,这凸显了对治疗这种疾病的进一步研究的需要.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
背景情况:
- 抗性高血压 (RH) 会增加心血管和脏并发症的风险.
- 目前的RH管理包括生活方式的改变,药物组合和脏缩.
- 新的治疗标和化合物正在进行RH治疗的研究.
研究的目的:
- 评估抗性高血压新药药理学药物的有效性.
- 在临床试验中评估firibastat,aprocitentan和baxdrostat的疗效和安全性.
主要方法:
- 费里巴斯塔特在耐性高血压 (FRESH) 试验中评估了一种中央作用药物.
- 在PRECISION试验中,评估了aprocitentan,这是一个双重内甲素受体对抗剂.
- 抗性高血压 (BrigHTN) 和HALO试验中的巴克斯德罗斯塔特研究了一种选择性阿尔多合成酶抑制剂.
主要成果:
- 在FRESH试验中,Firibastat没有显示出明显的BP降低.
- 在PRECISION试验中,阿普罗西坦坦显示了适度的血压降低,并引起了液体保留问题.
- 巴克斯德罗斯坦在BrigHTN中初步表现有希望,但未能达到HALO的终点,可能是由于附着性或白衣高血压.
结论:
- 管理抗性高血压仍然是一个重大的临床挑战.
- 针对各种途径的新化合物已经显示出不一致的有效性.
- 为了充分理解和优化RH的治疗策略,进一步的研究是必不可少的.
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