ALLSCHWIL, Switzerland, June 1, 2026
Idorsia Ltd announced new Phase 3 PRECISION study analyses showing that aprocitentan, its dual endothelin receptor antagonist marketed as TRYVIO™ in the U.S. and JERAYGO™ in Europe, significantly reduced albuminuria and improved kidney risk categories in patients with uncontrolled or resistant hypertension. The data, presented at the 35th Congress of the European Society of Hypertension (ESH), highlight the drug’s potential to not only lower blood pressure but also reduce the risk of chronic kidney disease progression, cardiovascular complications, and mortality. Albuminuria is a recognized marker of kidney damage and elevated cardiovascular risk, making these findings particularly important for patients with difficult-to-control hypertension and associated comorbidities such as type 2 diabetes and chronic kidney disease.
Significant and Sustained Reduction in Albuminuria
The analysis included 730 patients with confirmed resistant hypertension receiving at least three antihypertensive medications, including a diuretic. Treatment with aprocitentan 25 mg produced rapid and substantial reductions in urine albumin-creatinine ratio (UACR) as early as Week 4 compared with placebo. By Week 36, patients with microalbuminuria experienced a reduction in average UACR from 77.5 mg/g to 34 mg/g, while those with macroalbuminuria saw levels decline from 860.2 mg/g to 286.7 mg/g. Nearly half of patients with elevated albuminuria achieved a lower-risk category after long-term treatment, while more than 92% of patients with normal baseline albumin levels maintained healthy kidney status throughout therapy. These results suggest that endothelin receptor blockade may offer meaningful renal protection beyond traditional blood pressure management.
Potential to Reduce Kidney and Cardiovascular Risk
Researchers noted that improvements in albuminuria were accompanied by stable estimated glomerular filtration rate (eGFR), indicating preserved kidney function. According to study investigator Prof. Markus Schlaich, the ability of aprocitentan to lower albuminuria risk categories in a substantial proportion of patients supports its potential to transform treatment strategies for resistant hypertension.
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Because elevated albuminuria is strongly linked to progression toward kidney failure, cardiovascular events, and premature death, the findings suggest that aprocitentan may provide long-term protection against serious complications. Importantly, the benefits were observed in high-risk populations, including patients with diabetes, obesity, chronic kidney disease, congestive heart failure, and older adults.
Novel Endothelin Pathway Targeting Supports Broad Clinical Use
Aprocitentan is the first approved systemic hypertension therapy specifically targeting the endothelin pathway, a biological system associated with vasoconstriction, inflammation, fibrosis, and organ damage. Unlike some therapies that affect the renin-angiotensin-aldosterone system and may increase the risk of hyperkalemia, aprocitentan has not shown significant electrolyte-related safety concerns.
Previous PRECISION data demonstrated durable blood pressure reductions over 48 weeks, while the latest findings further strengthen evidence supporting its broader cardiovascular and renal benefits. With approvals already secured in the United States, European Union, United Kingdom, and Switzerland, and regulatory review ongoing in Canada, Idorsia continues to position aprocitentan as a potentially important treatment option for patients with resistant and difficult-to-control hypertension.
Source: Idorsia press release
