KARDIA-2: zilebesiran adds up to 12.1 mmHg of pressure lowering on top of standard pills

Alnylam Pharmaceuticals/Zilebesiran

In 672 patients whose blood pressure stayed high on one standard drug, a single 600 mg zilebesiran dose lowered 24-hour systolic pressure further at three months. The extra drop was largest with the diuretic indapamide and smallest with olmesartan, a drug that already blocks the same hormone chain.

• Added 24-hour systolic drop vs placebo: 12.1 mmHg with indapamide, 9.7 with amlodipine, 4.0 with olmesartan.
• High potassium readings in 3.2-6.8% of treated patients (1.3-1.7% confirmed on retest); kidney-filtering dips were mostly mild and reversed within 1-2 weeks.
• No deaths and no discontinuations for side effects in the six-month blinded period.