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
{"title":"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。","authors":"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","doi":"10.1111/jch.70155","DOIUrl":null,"url":null,"abstract":"<p>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; <i>p</i> = 0.0041; <i>p</i><sup>2</sup> = 0%) and diastolic BP (MD: −3.49 mmHg; 95% CI: −5.56 to −1.41; <i>p</i> = 0.0010; <i>I</i><sup>2</sup> = 0%). While office SBP showed a non-significant reduction in the primary analysis (MD: −13.55 mmHg; <i>p</i> = 0.077; <i>I</i><sup>2</sup> = 94%), it became statistically significant in a sensitivity analysis (MD: −9.08 mmHg; <i>p </i>< 0.0001). Lorundrostat also significantly lowered the risk of severely elevated BP events (odds ratio [OR]: 0.37; 95% CI: 0.17–0.81; <i>p</i> = 0.028). Adverse effects included an increased risk of hyperkalemia (OR: 3.22; <i>p </i>< 0.001) and hyponatremia (OR: 2.16; <i>p</i> = 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.</p>","PeriodicalId":50237,"journal":{"name":"Journal of Clinical Hypertension","volume":"27 9","pages":""},"PeriodicalIF":2.5000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jch.70155","citationCount":"0","resultStr":"{\"title\":\"Efficacy and Safety of Lorundrostat in Uncontrolled Hypertension: A Systematic Review and Meta-Analysis\",\"authors\":\"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\",\"doi\":\"10.1111/jch.70155\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>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; <i>p</i> = 0.0041; <i>p</i><sup>2</sup> = 0%) and diastolic BP (MD: −3.49 mmHg; 95% CI: −5.56 to −1.41; <i>p</i> = 0.0010; <i>I</i><sup>2</sup> = 0%). While office SBP showed a non-significant reduction in the primary analysis (MD: −13.55 mmHg; <i>p</i> = 0.077; <i>I</i><sup>2</sup> = 94%), it became statistically significant in a sensitivity analysis (MD: −9.08 mmHg; <i>p </i>< 0.0001). Lorundrostat also significantly lowered the risk of severely elevated BP events (odds ratio [OR]: 0.37; 95% CI: 0.17–0.81; <i>p</i> = 0.028). Adverse effects included an increased risk of hyperkalemia (OR: 3.22; <i>p </i>< 0.001) and hyponatremia (OR: 2.16; <i>p</i> = 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. 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Efficacy and Safety of Lorundrostat in Uncontrolled Hypertension: A Systematic Review and Meta-Analysis
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.
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.