Mineralocorticoid Receptor Antagonists for Hypertension Management in Advanced Chronic Kidney Disease: BLOCK-CKD Trial.

Hypertension
George BakrisBertram Pitt

Abstract

Spironolactone, a steroidal mineralocorticoid receptor antagonist, is recommended as add-on therapy for treatment-resistant/uncontrolled hypertension. However, caution is advised in patients with advanced chronic kidney disease (CKD) due to an increased risk for hyperkalemia. KBP-5074 is a nonsteroidal mineralocorticoid receptor antagonist under investigation for the treatment of treatment-resistant and uncontrolled hypertension in patients with moderate-to-severe CKD. BLOCK-CKD is a phase 2, international, multicenter, randomized, double-blind, placebo-controlled, parallel-group study to evaluate the efficacy and safety of KBP-5074, on top of current therapy, in patients with stage 3B/4 CKD (estimated glomerular filtration rate ≥15 and ≤44 mL/[min·1.73 m2]) and resistant hypertension (trough cuff seated systolic blood pressure ≥140 mm Hg, despite treatment with maximally tolerated doses of 2 or more antihypertensive medicines with complementary mechanisms). Patients (n=240) will be randomized 1:1:1 to once-daily treatment with KBP-5074 0.25 mg, KBP-5074 0.5 mg, or placebo, stratified by estimated glomerular filtration rate (≥30 versus <30 mL/[min·1.73 m2]) and systolic blood pressure (≥160 versus <160 mm Hg). Approximately 30%...Continue Reading

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Citations

Aug 18, 2020·Expert Opinion on Drug Safety·Steven G Chrysant, George S Chrysant
Sep 6, 2020·Reviews in Endocrine & Metabolic Disorders·Yanduan LinJiao Guo
Sep 29, 2020·American Journal of Physiology. Renal Physiology·Dominique M BoveeEwout J Hoorn
Nov 13, 2020·Drug Development Research·Vishal PatelMukul Jain
Dec 6, 2020·Journal of Cardiovascular Pharmacology·Christopher S Wilcox, Bertram Pitt
May 11, 2021·Hypertension·George BakrisUNKNOWN BLOCK-CKD Study Group
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Nov 18, 2021·British Journal of Pharmacology·Jonatan Barrera-ChimalHans-Joachim Anders
Nov 24, 2021·British Journal of Pharmacology·Ulrich KintscherPeter Kolkhof

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