American journal of hypertension · 2026
Lorundrostat for Patients With Uncontrolled Hypertension: A Systematic Review With Meta-Analysis and Trial Sequential Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ribeiro Vicente Morales, Cavalcante Douglas Nunes, Celkevicius Hermes Estevam Torega, Camacho Giovanna Cristina Gonçalves, Neves Henrique Alexsander Ferreira, de Souza Kevlin, Machado Rafael Henkes, Lopes Lucca Moreira, Donaldy Webster, Bortolotto Luiz Aparecido, Schneider Jamil Cherem
Аннотация
BACKGROUND: The efficacy and safety of lorundrostat, a selective aldosterone synthase inhibitor, in patients with uncontrolled hypertension remain unclear. This meta-analysis aimed to evaluate its effects on blood pressure and risk of hyperkalemia.
METHODS: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were systematically searched through July 2025 for randomized controlled trials comparing lorundrostat with placebo. Pooled mean differences (MD) and risk ratios (RR) with 95% CIs were estimated using a random-effects model with the Restricted Maximum Likelihood estimator. Trial sequential analysis (TSA) was conducted to assess the conclusiveness of safety evidence.
RESULTS: Three RCTs including 1060 patients were identified. Lorundrostat significantly reduced systolic blood pressure at 50 mg (MD, -9.08 mmHg; 95% CI, -13.14 to -5.03) and 100 mg (MD, -11.41 mmHg; 95% CI, -15.97 to -6.85), and diastolic blood pressure at 50 mg (MD, -3.48 mmHg; 95% CI, -5.98 to -0.98). However, lorundrostat increased the risk of hyperkalemia at 50 mg (RR, 6.56; 95% CI, 1.53-28.12; NNH = 71) and 100 mg (RR, 10.37; 95% CI, 2.44-44.03; NNH = 42). TSA confirmed hyperkalemia at 100 mg as the only conclusive harm signal, while other safety outcomes remained inconclusive.
CONCLUSIONS: Lorundrostat effectively lowered blood pressure but increased dose-dependent risk of hyperkalemia. These findings support its potential as a novel therapy for uncontrolled hypertension, while emphasizing the need for longer-term cardiovascular outcome trials and direct comparisons with mineralocorticoid receptor antagonists concerning efficacy and safety.
METHODS: PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were systematically searched through July 2025 for randomized controlled trials comparing lorundrostat with placebo. Pooled mean differences (MD) and risk ratios (RR) with 95% CIs were estimated using a random-effects model with the Restricted Maximum Likelihood estimator. Trial sequential analysis (TSA) was conducted to assess the conclusiveness of safety evidence.
RESULTS: Three RCTs including 1060 patients were identified. Lorundrostat significantly reduced systolic blood pressure at 50 mg (MD, -9.08 mmHg; 95% CI, -13.14 to -5.03) and 100 mg (MD, -11.41 mmHg; 95% CI, -15.97 to -6.85), and diastolic blood pressure at 50 mg (MD, -3.48 mmHg; 95% CI, -5.98 to -0.98). However, lorundrostat increased the risk of hyperkalemia at 50 mg (RR, 6.56; 95% CI, 1.53-28.12; NNH = 71) and 100 mg (RR, 10.37; 95% CI, 2.44-44.03; NNH = 42). TSA confirmed hyperkalemia at 100 mg as the only conclusive harm signal, while other safety outcomes remained inconclusive.
CONCLUSIONS: Lorundrostat effectively lowered blood pressure but increased dose-dependent risk of hyperkalemia. These findings support its potential as a novel therapy for uncontrolled hypertension, while emphasizing the need for longer-term cardiovascular outcome trials and direct comparisons with mineralocorticoid receptor antagonists concerning efficacy and safety.