A new injection given twice a year shows promise for patients whose blood pressure refuses to budge despite taking standard medications. Researchers at Queen Mary University of London published findings in JAMA showing that zilebesiran, an experimental drug administered subcutaneously, achieved greater reductions in blood pressure when added to existing treatment regimens.
The KARDIA-2 trial enrolled 663 adults with poorly controlled hypertension across multiple countries. Participants who received the six-month injection alongside their regular blood pressure drugs experienced superior outcomes compared to those continuing standard therapy alone.
High blood pressure affects roughly one in three UK adults and ranks as a leading cause of heart attacks, strokes, and premature death. Current treatment options rely heavily on daily medications, which creates compliance challenges and leaves many patients with inadequate control.
Zilebesiran uses RNA interference technology to target angiotensinogen, a protein produced in the liver that plays a central role in blood pressure regulation. By suppressing this protein, the drug allows blood vessels to relax and pressure to fall. The injectable formulation means patients receive treatment twice yearly rather than managing a daily pill regimen.
Dr. Manish Saxena, clinical co-director of the William Harvey Clinical Research Centre and a hypertension specialist at Barts Health NHS Trust, led the UK arm of the study. "This study demonstrates the efficacy and safety of zilebesiran when added to commonly used first line blood pressure lowering drugs," Saxena said. "The novelty of this treatment is its long duration; giving just one injection every six months could help millions of patients to better manage their condition."
Researchers are moving forward with KARDIA-3, a Phase 2 study exploring whether zilebesiran benefits patients with established cardiovascular disease or high risk for such conditions. A larger global outcomes trial scheduled for later this year will examine whether the drug reduces the risk of major cardiovascular events including strokes and cardiac death.
Alnylam Pharmaceuticals funded the research. Barts Health NHS Trust served as a lead site and top enrolling center in Europe.
Author Jessica Williams: "If these results hold up in larger trials, this could reshape how millions manage a disease that kills more people than almost anything else."
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