Evaluating esaxerenone for treating night-time hypertension

This study compared the effect of esaxerenone (Minnebro) to eplerenone (Inspra) on night-time blood pressure (BP). It found that esaxerenone had a greater effect on night-time BP than eplerenone.  

Normally, BP is 10-20% lower during the night compared to day-time BP. Night-time increases in BP are associated with an increased risk of stroke, heart attack, and organ damage. Eplerenone is an anti-hypertension (high BP) medication that blocks the hormone aldosterone. Esaxerenone is a new BP-lowering medication that has been shown to be as effective as eplerenone in lowering BP. However, the effect of esaxerenone on night-time BP has not been shown.

1,001 patients with high BP participated in this study. BP was measured every 30 minutes for 25 hours before starting treatment. 331 patients received esaxerenone 2.5 mg/day, 338 patients received esaxerenone 5 mg/day, and 332 patients received eplerenone 50 mg/day. After 12 weeks BP was measured again over a 25 hour period.

All groups saw significant reductions in the daytime and nighttime BP after treatment. However, after 12 weeks the esaxerenone groups showed a bigger drop in nighttime BP than the eplerenone group. Patients receiving esaxerenone 2.5 mg had a reduction in nighttime systolic BP of 2.5 mmHg more than the eplerenone group. Patients receiving esaxerenone had a BP reduction of 6.4 mmHg more than the eplerenone group. In patients with normal nighttime BP levels, esaxerenone did not significantly modify nighttime BP levels.

This study showed that esaxerenone is more effective at lowering night-time BP than eplerenone.

This study was funded by Daiichi Sankyo, the company that produces esaxerenone. Only Japanese patients were included, so more studies may be needed to see if these results apply to patients of other ethnicities.