Baxdrostat, a medication currently approved in the United States for treatment-resistant hypertension, may offer a permanent cure for high blood pressure caused by adrenal gland tumours. A recent analysis published in The New England Journal of Medicine suggests that a finite course of the drug can eliminate hormone-producing cells.
Baxdrostat Blocks Aldosterone Production to Destroy Overproducing Cells
- The Mechanism: Baxdrostat inhibits the production of aldosterone, a hormone that raises blood pressure. By blocking this, the drug induces a process that leads to the death of the cells that overproduce the hormone, located in the adrenal glands, on top of the kidneys.
- The Potential Cure: Unlike traditional antihypertensives that require lifelong adherence, this treatment aims for a sustained remission, potentially replacing the need for major adrenal surgery.
- The Timeline: While currently available in the US for specific patients, the drug is likely to become available in Britain next year, pending regulatory review by the National Institute for Health and Care Excellence (NICE).
The Mechanism of Adrenal Cell Ablation
High blood pressure, or hypertension, is often managed through chronic medication, but for one in 10 people, the root cause is tiny benign tumours in their adrenal glands. These growths cause the body to overproduce aldosterone, a hormone that raises blood pressure. The drug baxdrostat was initially engineered to block this hormonal pathway.
However, investigators observed an unexpected clinical effect: the drug appears to trigger a process that leads to the death of the hormone-producing tumour cells. Professor Morris Brown, a heart specialist at Queen Mary University of London, explains that blocking the hormone generates reactive oxygen species—energetic compounds that are very harmful to the cell.
Patients Maintain Lower Blood Pressure After Stopping Medication
These discoveries stem from an evaluation of a broader study originally conducted to secure clearance for baxdrostat to function as a lifelong antihypertensive therapy. During the initial three-month study phase, 14 patients who had experienced large improvements recorded an average systolic blood pressure reduction of 25 millimetres of mercury.
Following the trial, these patients continued the medication for six to 12 months before stopping. Astonishingly, over a follow-up period lasting up to two years, these individuals have maintained their reduced blood pressure levels. One person of the group has been off the drug for three years. While these results are promising, researchers emphasize that a larger study is now under way to really prove this.
| Metric | Observation |
|---|---|
| Primary Target | Aldosterone-producing adrenal tumours |
| Observed BP Drop | Average 25 mmHg (systolic) |
| Current Status | US Approved; UK NICE review pending |
Nice Assesses Baxdrostat for Patients with Dangerous Blood Pressure
The path to clinical adoption in the United Kingdom involves an assessment by NICE. The drug is currently under consideration for people whose blood pressure is still dangerously high despite taking two or more other drugs. This specific cohort is more likely to have the adrenal gland tumours as the cause.
Harvard Medical School professor of medicine Mason Freeman remarked that such enduring remission presents the thrilling prospect that numerous sufferers of [adrenal gland tumours] could receive a daily oral medication for a potentially restricted duration, yielding outcomes comparable to those currently attainable solely through extensive adrenal operations. If approved for NHS use, this could benefit over a million people in Britain.
