ראשי » סקירה » האם הנוגדן לאלדוסטרון Lorundrostat מוריד את לחץ הדם בחולי יל"ד עמיד לתרופות?

האם הנוגדן לאלדוסטרון Lorundrostat מוריד את לחץ הדם בחולי יל"ד עמיד לתרופות?

מפרסם: פרופ' יאיר יודפת

מטרת השלב III במחקר ADVANCE HTN שהיה מבוקר פלצבו היתה לבדוק האם טיפול ב – Lorundrostat הוא יעיל במבוגרים שסובלים מיל"ד עמיד לטיפול למרות טיפול ב – 2-5 תרופות לפחות אחת תיאזידית. נכללו 285 מבוגרים (40% נשים, 53% שחורים) שטופלו ב – Lorundrostat במינון של 50 מ"ג ליום בנוסף לאולמסרטן, אמדןדיפין ואינדאפמיד. נמצאה ירידה אבסולוטית של 16.9 ממ"כ בלחץ הדם לעומת פלצבו מתוקנן של 9.1 ממ"כ לאחר 6 שבועות. ירידה נוספת של 19 ממ"כ לעומת 11.7 ממ"כ בטיפול מתוקנן פלצבו שנמצאה לאחר 12 שבועות. חולים בהם הועלה המינון ל – 100 מ"ג ליום לאחר 6 שבועות הראו ירידה של 15.7 ממ"כ לעומת 8.4 ממ"כ בטיפול בפלצבו מתוקנן לאחר 12 חודשים. השינוי בתגובת לחץ הדם ל – Lorundrostat בחולים שצרכו 3 תרופות או 3-5 תרופות היה דומה. רמת האשלגן עלתה מעל 6 בקרב 5.35% מהמשתתפים ו – 7.4% במינונים 50 ו – 100 מ"ג. Lorundrostat הוא מעכב aldosterone synthase שמוריד את רמת האלדוסטרון ע"י עיכוב CYP11B2 האנזים שאחראי ליצירתו. במחקרים שונים נמצאה ירידה של כ – 70% ביצירתו בחולי יל"ד. ההנחה היא שלהורדה משמעותית זאת תהיה השפעת מרבית על הורדת הסיכון למחלה CV.

נחכה לפרסום המלא של מחקר זה.

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