Efficacy and Safety of Ocedurenone: Subgroup Analysis of the BLOCK-CKD Study

• Published in: American journal of hypertension 2023-11, Vol.36 (11), p.612-618
• Main Authors: Bakris, George L, Yang, Y Fred, McCabe, James M, Liu, Jin Rong, Tan, Xiaojuan J, Benn, Vincent J, Pitt, Bertram
• Format: Article
• Language: English
• Subjects: Original Contributions
• ISSN: 0895-7061; 1941-7225
• DOI: 10.1093/ajh/hpad066

Abstract BACKGROUND Ocedurenone (KBP-5074), a nonsteroidal mineralocorticoid receptor antagonist, is documented to lower blood pressure in patients with stage 3b/4 chronic kidney disease (CKD) with uncontrolled or resistant hypertension (BLOCK-CKD study). However, the efficacy and safety of Ocedurenone in subgroups such as Hispanic patients or those with stage 4 CKD, diabetes, or very high albuminuria have not been reported. METHODS A total of 162 patients were enrolled in the BLOCK-CKD study. The primary endpoint of these analyses was change in systolic blood pressure (SBP) from baseline to day 84. Prespecified subgroup analysis of SBP focused on demographic (e.g., ethnicity, age) and medical (e.g., CKD stage, diabetes, albuminuria, baseline estimated glomerular filtration rate [eGFR]). The safety analysis focused on changes in serum potassium levels from baseline. RESULTS SBP reductions were consistent across subgroups compared with the overall study cohort. Placebo-adjusted SBP reductions were observed in Hispanic patients (−8.1 and −9.9 mm Hg for 0.25 and 0.5 mg, respectively, total n = 35) and patients with CKD stage 4 (−9.3 and −10.4 mm Hg for 0.25 and 0.5 mg, respectively, total n = 64), diabetes (−6.9 and −11.6 mm Hg for 0.25 and 0.5 mg, respectively, total n = 51), and very high albuminuria (−13.1 and −12.3 mm Hg for 0.25 and 0.5 mg, respectively, total n = 85). Changes in serum potassium were similar across all patient subgroups regardless of baseline eGFR, diabetes status, or degree of proteinuria. No cases of hyperkalemia required intervention or resulted in study discontinuation. CONCLUSIONS Ocedurenone consistently reduced in SBP in all patient subgroups. Moreover, while small elevations in serum potassium occurred, they were not associated with Ocedurenone or study discontinuation. Graphical Abstract