The Journal of Clinical Hypertension (Jul 2023)

Aprocitentan: A new development of resistant hypertension

  • Yao Yao,
  • Bin Fan,
  • Bin Yang,
  • Zixuan Jia,
  • Bao Li

DOI
https://doi.org/10.1111/jch.14686
Journal volume & issue
Vol. 25, no. 7
pp. 587 – 590

Abstract

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Abstract As the blood pressure threshold for commencing antihypertensive treatment diminishes, the cohort suffering from resistant hypertension (RH) correspondingly expands. Notwithstanding the availability of known antihypertensive medications, there exists a conspicuous lacuna in therapeutic options specifically intended for the management of RH. Currently, aprocitentan is the sole endothelin receptor antagonist (ERA) under development for addressing this pressing clinical challenge. Aprocitentan (ACT‐132577), deriving its active form as a metabolite of macitentan, demonstrates oral potency as a dual endothelin (ET) receptor antagonist. This compound effectively obstructs the binding of endothelin‐1 (ET‐1) to both ETA and ETB receptors, exhibiting an inhibitory potency ratio of 1:16. Clinical investigation of aprocitentan has advanced to phase 3 trials, yielding promising preliminary outcomes.

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