Abstract: TH-OR038
Blood Pressure and Albuminuria Reduction with Lorundrostat in CKD Stages 1 to 3 in the Launch-HTN Trial
Session Information
- Cardiovascular-Kidney-Metabolic Syndrome: Trials, Mechanisms, and Population Health
October 22, 2026 | Location: Room 205, Convention Center
Abstract Time: 04:40 PM - 04:50 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Vogt, Liffert, Amsterdam UMC Locatie AMC, Amsterdam, NH, Netherlands
- Heagerty, Patrick James, University of Washington, Seattle, Washington, United States
- Bhaduri, Sarbani, Mineralys Therapeutics Inc, Radnor, Pennsylvania, United States
Background
Hypertension (HTN) and albuminuria are the leading modifiable risk factors that impact cardiorenal morbidity and mortality in chronic kidney disease (CKD) patients. Up to ~75% of CKD patients have uncontrolled HTN (uHTN). Lorundrostat (LOR), a highly selective aldosterone synthase inhibitor (ASI), demonstrated efficacy in the global Launch-HTN trial, one of the largest phase 3 trials of an ASI in difficult-to-treat HTN. The current analysis examines the efficacy and safety of LOR in reducing automated office systolic BP (AOSBP) and urine albumin-to-creatinine ratio (UACR) in participants with CKD.
Methods
This analysis included 808 participants with uHTN concurrently receiving >2 BP lowering medications who received either once daily LOR 50mg (N=538) or placebo (PBO) (N=270) in the Launch-HTN trial. CKD was defined as eGFR <60mL/min/1.73m2 or UACR ≥30mg/g. AOSBP changes from baseline were examined in CKD stages 1 to 3. Serum potassium and eGFR were evaluated.
Results
Placebo-adjusted reduction in AOSBP was -12.2 mmHg and -9.6 mmHg in participants without and with CKD, respectively (Table). Placebo-adjusted percent change in geometric mean UACR in LOR 50mg participants with baseline albuminuria at week 12 was -52.2% (95% CI, -64.0 to -36.6; P<0.001). Among participants receiving LOR 50mg, confirmed serum potassium >6.0 mmol/L occurred in 3 (2.4%) CKD participants and in none of the non-CKD participants. In LOR 50mg participants, mean cystatin C-based eGFR decreased by 7.3, 4.0 and 4.2 mL/min/1.73 m2 in those with CKD stage 1, 2, and 3, respectively, compared with 2.1 mL/min/1.73 m2 in those without CKD.
Conclusion
LOR has similar, clinically meaningful, reduction in AOSBP and an acceptable safety profile in uHTN participants with- and without CKD. There was a significant reduction in UACR in participants with baseline albuminuria. The findings support LOR as a potential therapeutic strategy for cardiorenal risk reduction in patients with CKD and uHTN.
Table
| Study arm | PBO | LOR 50mg | ||||||
| CKD stage (n)a | No CKD (N=202) | Stage 1 (N=30) | Stage 2 (N=25) | Stage 3 (N=10) | No CKD (N=406) | Stage 1 (N=58) | Stage 2 (N=31) | Stage 3 (N=38) |
| AOSBP LSM (95%CI) change at Week 12 | -7.2 (-11.3, -3.2) | -8.9 (-15.4, -2.3) | -9.1 (-15.9, -2.4) | -8.5 (-18.1, 1.1) | -19.4 (-22.2, -16.6) | -19.5 (-24.1, -14.9) | -16.7 (-22.6, -10.8) | -18.5 (-24.1, -13.0) |
| Placebo adjusted (95%CI) | -12.2 (-17.1, -7.3) | -10.6 (-18.6, -2.6) | -7.6 (-16.5, 1.4) | -10.1 (-21.1, 1.0) | ||||
| Week 12 % with AOSBP <130 mmHg | 22.1 | 18.4 | 12.0 | 30.0 | 48.0 | 50.6 | 28.4 | 47.0 |
| aKDIGO 2012 Stage 1 eGFR ≥90 and UACR ≥30; Stage 2 eGFR 60-89 and UACR ≥30; Stage 3a eGFR 45-59; Stage 3b eGFR 30-44; Stage 4 eGFR 15-29. Stage 3 in this analysis includes Stage 3a (PBO=9, LOR=34) and Stage 3b (PBO=1 and LOR=4). LOR, lorundrostat; PBO, placebo. Note: For UACR analysis 5 participants in LOR 50mg and 3 participants in PBO did not have baseline UACR and were excluded from the analyses. | ||||||||
Funding
- Commercial Support – Mineralys Therapeutics Inc.