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Prerna Tejaswi

 

Prerna Tejaswi

Dr. MGR Educational and Research Institute, India

Abstract Title: Aprocitentan, a New Chapter in the Pharmacotherapy of Resistant Hypertension: A Systematic Review

Biography: Dr. Prerna Tejaswi is currently an Assistant Professor, Department of Pharmacology at Rajarajeswari Medical College and Hospital, affiliated to Dr. MGR Educational and Research Institute (University) Chennai, India. She has completed her MBBS from Rajiv Gandhi University of Health Sciences, Bangalore, India and her MD (Pharmacology) from Madhya Pradesh Medical Science University, Jabalpur, India. She has more than 10 papers against her name in reputed journals and 2 studies are underway.

Research Interest: Conventional antihypertensive strategies have not targeted endothelin, although endothelin pathway is frequently activated in patients prone to developing resistant hypertension. Objective: To generate comprehensive data on the efficacy, safety and tolerability of aprocitentan on patients with resistant hypertension and to note the unmet need or gap in the therapy.Methods: PRISMA checklist used and PROSPERO registration was done (CRD420261281689). Online databases were searched for original articles on new drug aprocitentan (Endothelin Receptor Antagonist). Qualitative assessment was done after full text screening and data extraction.Results: Main outcome from baseline to week 4 in subjects with chronic kidney disease, aprocitentan 12.5 and 25 mg reduced mean sitting office systolic blood pressure by −13.5 and −16.6 mm Hg, respectively while placebo −4.4 mm Hg, Changes in urine albumin-to-creatinine ratio were −47.1%, and −59.6%, compared to placebo −2.4%.With β-blockers, 12.5 mg and 25 mg aprocitentan decreased systolic blood pressure from baseline to Week 4 by mean -14.9 mmHg and -14.9 mmHg, respectively, vs -11.2 mmHg in the placebo group; and in patients without β-blockers by -16.5 mmHg and -14.9 mmHg vs -11.8 mmHg. Post 4 weeks of withdrawal, office systolic blood pressure increased with placebo versus aprocitentan (5•8 mm Hg, p<0•0001). Common adverse effect was oedema, occurring in 9%, 18%, and 2% for patients receiving aprocitentan 12•5 mg, 25 mg, and placebo, respectively. Pharrmacokinetics of aprocitentan were similar with moderate hepatic impairment and healthy subjects. Aprocitentan was well tolerated in severe renal function impairment.Conclusion: Aprocitenatan is a valuable discovery for resistant hypertension.