Efficacy and Safety of Lorundrostat in Uncontrolled Hypertension: A Systematic Review and Meta-Analysis

IF 2.5 3区 医学 Q2 PERIPHERAL VASCULAR DISEASE
Allah Dad, Kinza Bakht, Haris Bin Tahir, Muhammad Arham, Anika Goel, Malik Maaz Ahmad, Soban Raza, Syeda Hafsa Qadri, Diya Rathi, Saad Javed, Syed Shah Qasim Hamdani, Hasnan Arshad, F. N. U. Abubakar, Muhammad Nauman Awais, Muhammad Abdullah Nizam
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Abstract

This systematic review and meta-analysis evaluated the efficacy and safety of lorundrostat in adults with uncontrolled hypertension. Following PRISMA guidelines and PROSPERO registration (CRD420251088503), five databases were systematically searched through July 2025 for randomized controlled trials comparing lorundrostat with placebo in this population. The primary outcome was change in systolic blood pressure (SBP), while secondary outcomes included diastolic blood pressure, severe BP events, and adverse effects. Three RCTs comprising 1568 participants across 10 study arms were included. Lorundrostat significantly reduced 24-h ambulatory SBP (mean difference [MD]: –7.45 mmHg; 95% CI: −12.54 to −2.36; p = 0.0041; p2 = 0%) and diastolic BP (MD: −3.49 mmHg; 95% CI: −5.56 to −1.41; p = 0.0010; I2 = 0%). While office SBP showed a non-significant reduction in the primary analysis (MD: −13.55 mmHg; p = 0.077; I2 = 94%), it became statistically significant in a sensitivity analysis (MD: −9.08 mmHg; p < 0.0001). Lorundrostat also significantly lowered the risk of severely elevated BP events (odds ratio [OR]: 0.37; 95% CI: 0.17–0.81; p = 0.028). Adverse effects included an increased risk of hyperkalemia (OR: 3.22; p < 0.001) and hyponatremia (OR: 2.16; p = 0.037), with no significant difference in serious adverse events between groups. In conclusion, lorundrostat demonstrates significant reductions in both ambulatory and diastolic BP in patients with uncontrolled hypertension, with a generally tolerable safety profile. Hyperkalemia and hyponatremia remain notable risks. Further long-term trials are warranted to validate its sustained efficacy and safety.

Abstract Image

Lorundrostat治疗未控制高血压的疗效和安全性:一项系统综述和荟萃分析。
本系统综述和荟萃分析评估了洛诺他在成人未控制高血压患者中的疗效和安全性。遵循PRISMA指南和PROSPERO注册(CRD420251088503),系统检索了5个数据库,以比较lorundrostat和安慰剂在该人群中的随机对照试验。主要结局是收缩压(SBP)的改变,次要结局包括舒张压、严重的BP事件和不良反应。纳入了三个随机对照试验,包括10个研究组的1568名参与者。洛undrostat显著降低24小时动态收缩压(平均差[MD]: -7.45 mmHg; 95% CI: -12.54至-2.36;p = 0.0041; p2 = 0%)和舒张压(MD: -3.49 mmHg; 95% CI: -5.56至-1.41;p = 0.0010; I2 = 0%)。虽然办公室收缩压在初步分析中显示无显著降低(MD: -13.55 mmHg; p = 0.077; I2 = 94%),但在敏感性分析中具有统计学意义(MD: -9.08 mmHg; p
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来源期刊
Journal of Clinical Hypertension
Journal of Clinical Hypertension PERIPHERAL VASCULAR DISEASE-
CiteScore
5.80
自引率
7.10%
发文量
191
审稿时长
4-8 weeks
期刊介绍: The Journal of Clinical Hypertension is a peer-reviewed, monthly publication that serves internists, cardiologists, nephrologists, endocrinologists, hypertension specialists, primary care practitioners, pharmacists and all professionals interested in hypertension by providing objective, up-to-date information and practical recommendations on the full range of clinical aspects of hypertension. Commentaries and columns by experts in the field provide further insights into our original research articles as well as on major articles published elsewhere. Major guidelines for the management of hypertension are also an important feature of the Journal. Through its partnership with the World Hypertension League, JCH will include a new focus on hypertension and public health, including major policy issues, that features research and reviews related to disease characteristics and management at the population level.
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