Lorundrostat

中国现有近3亿高血压患者，控制达标率仅约16.8%每100个高血压患者里，只有不到17个人真正把血压管住了。想象一下，这意味着绝大多数人的血压像个没被看紧的阀门，随时可能爆发。 血压不降，不是因为病人懒。 而是我们手里的武器不够锋利。 很多人吃了两三种药，血压还是高高挂着。这类病人，被称作“难治性高血压”。 问题的幕后黑手之一，是一种叫醛固酮的激素。 它会让肾脏把钠留住，水也跟着多起来。血容量上去，血压自然上去。当醛固酮长期过多，降压就像往被放得鼓鼓的轮胎上继续充气越填越难收回。 医学界早就盯上这个靶点。可几十年的药物研发，始终卡在一处：醛固酮合成酶的结构，跟制造皮质醇的酶非常像。 皮质醇对生命至关重要。一不小心，抑制错了，就可能让人受更大的伤害。于是，很多候选药被淘汰。选择性，成了这场博弈的唯一通行证。 现在，有了新名字：Baxdrostat。 它带来的突破，用一句话解释很现实：精准得多了。Baxdrostat对醛固酮合成酶的抑制选择性高达100:1精准锁定靶点，对皮质醇合成几乎不产生干扰。 证据来自大型临床试验。 《新英格兰医学杂志》发布的III期临床试验结果，纳入全球214家医院、796名已接受两种或以上降压药治疗但血压仍未达标的患者。 试验中，患者用药3个月后，Baxdrostat组的收缩压下降了14.5至15.7 mmHg。相比安慰剂组，多降了约9至10 mmHg。 更让人吃惊的是停药后的表现。 研究在用药6个月后安排了停药观察。停药后数月内，Baxdrostat组患者的血压仍能维持相当程度的控制。 这在现有降压药里少见。上海瑞金医院心内科的陈桢玥教授也指出，这种停药期的效果提示该药或具“疗效延时效应”，未来可能帮医生做更灵活的减药或逐步停药方案。 对中国人来说，意义不只是学术上的好奇。 中国是全球高盐饮食最具代表性的国家之一。高盐摄入会持续激活醛固酮系统，使得钠潴留更严重，而这恰是Baxdrostat瞄准的核心问题。 国内高血压人群里，钠敏感型占比不低。老年、肥胖、慢性肾病患者更常见这一路径。理论上，这类人群从醛固酮合成酶抑制剂中获益会更显著。 不仅Baxdrostat一枝独秀。另一款药物Lorundrostat也在《新英格兰医学杂志》发表了III期数据，相比安慰剂，降压量级亦在约10 mmHg左右。这说明，一个新的药物类别正在成形。 现实是，药物获批只是第一道门。 研发方计划今年底前提交监管申报数据。到目前为止，Baxdrostat在全球的系列临床试验累计入组已超20000人，研究方向覆盖单药、原发性醛固酮增多症、以及联合用药对慢性肾病和心衰的预防等。 接下来要解决的，是哪些具体的患者最能从中受益，以及长期随访能否真正把心脑血管事件降下来。 别误会，新药不是万能钥匙。 戒烟、限盐、减重、规律运动，这些依然是把血压拉回安全区最靠谱的底层办法。对血压在临界值的人来说，先改变生活方式，永远都比依赖药丸更稳妥。任何新药出现，都不能替代这些基础措施。 温馨提醒：本文仅作健康科普，不构成任何医疗建议。文中所述药物尚未在国内正式上市，具体用药请遵医嘱，切勿擅自调整治疗方案。 我们是否应该把“长期吃三四种药也不见效”的高血压患者标签为“医疗失败”，还是应当用新机制、新药来重新定义治疗边界？

→ Recursion has hired a new top doctor, bringing on Vicki Goodman as chief medical officer. Goodman previously served as CMO of the cancer biotechs Exelixis and Mural Oncology . She is taking over for David Mauro , who has been in the role for nearly three years. Goodman’s hiring is one of the biggest executive changes since Najat Khan took over as CEO at the start of 2026. → Pablo Cagnoni ’s job title at Incyte has been modified to president and global head of R&D, while longtime CMO Steven Stein will add to his responsibilities as head of late-stage development. CEO Bill Meury wasn’t done, naming J&J vet Mohamed Issa as head of US commercial. Issa had led the US oncology business and that won’t change with this role, but his leadership will extend to US immunology as well. Finally, Matteo Trotta — who came to Incyte in 2024 after 12 years at Novartis — is stepping down as US general manager, dermatology. Incyte has passed through Peer Review frequently since August, hiring a chief strategy officer, HR chief and general counsel. → Emil deGoma is a first-time CMO at Braveheart Bio , a new cardio bet that raised a $185 million Series A in November after doing a deal with Hengrui . The Akebia vet was SVP of medical research at Tourmaline Bio , which Novartis bought last year to boost a heart disease pipeline that already includes its blockbuster Entresto . “His background as an academic cardiologist and his industry experience advancing innovative medicines position him well to guide our clinical programs,” Braveheart CEO Travis Murdoch said in a statement. Murdoch sold HI-Bio to Biogen in 2024, and Braveheart is now chaired by Biogen CEO Chris Viehbacher . → David Marek quietly stepped down as CEO of ReAlta Life Sciences in October, according to his LinkedIn, and the Virginia-based biotech has tapped chairman Howard Berman as his successor. This is Berman’s first CEO appointment since he led Coya Therapeutics from 2020-24, and he has chaired the board at ReAlta since November. One more note: Madrigal Pharmaceuticals alum and ReAlta board member Kia Motesharei has been named president and COO. He had a short stint as an entrepreneur-in-residence at Formation Bio after more than two years with Madrigal as SVP, business & corporate development. → On March 30, Jennifer Jarrett will be president and CEO of Damora Therapeutics , which was purchased by Galecto and will carry on under the Damora name. Fairmount Funds founding partner Peter Harwin will chair the board, while Spyre Therapeutics CEO Cameron Turtle and ex- Blueprint Medicines finance chief Mike Landsittel are the newest board members. Jarrett had been a key member of the team at Arcus Biosciences in two separate stints since 2017, including the last five-plus years as COO. From 2019-20, she was head of corporate development and capital markets for Uber . You can also find her on the board of directors at Sagimet Biosciences , Syndax Pharmaceuticals and Zura Bio . → There’s a changing of the guard at Basel-based Anaveon . Andreas Katopodis is handing the CEO keys to Thaminda Ramanayake , who was recently chief business officer at CureVac , the mRNA biotech that he helped merge with rival BioNTech . Ramanayake is also a venture partner at the investment fund Entrée Bioventures . Anaveon is working on depleting pathogenic T cells for autoimmune diseases and inflammatory disorders. The company used to be clinical-stage with its initial goal of joining the IL-2 race , but that mission appears to have ended . Anaveon said it is backed by Syncona , Forbion , Blue Owl , Pontifax and the venture arms of Novartis and Pfizer . Anaveon’s chair is former Bayer CEO Dieter Weinand . → Two key execs have made their way to Averna Therapeutics , one of last year’s Endpoints 11 winners : CSO Robert Mabry worked for Averna CEO Tom Barnes in the same capacity at Orna Therapeutics , and Mabry has also been global head of biologics for Takeda . And Richard Morris has another CFO assignment following stints at Carisma Therapeutics , Passage Bio and Context Therapeutics . Averna’s focus on “jumping genes” — also known as retrotransposons — has additional competition . → France’s Abivax turned an experimental HIV drug ( obefazimod ) into a much-anticipated inflammatory disease treatment. As it prepares to take obefazimod to regulators, it has hired nine-year Takeda veteran Michael Nesrallah as its new chief commercial officer. Nesrallah filled multiple roles during his Takeda tenure, including general manager of Belgium, franchise head for IBD, leader of commercial operations for the US specialty business, and more. Obefazimod’s clinical success thus far in ulcerative colitis has drummed up M&A rumors. Alongside Nesrallah, Abivax also named Keith Fournier as SVP of global regulatory affairs and Maurus de la Rosa as SVP of research. Meanwhile, Sofinnova Partners ’ Kinam Hong stepped down from the board on March 19. → Led by ex- Prevail CEO Asa Abeliovich , neuro upstart Leal Therapeutics has brought in Johannes Tauscher as CMO, according to the search firm that helped with the appointment. Tauscher completed a dozen years with Takeda last summer and was the Japanese pharma’s global head of imaging. Leal broke cover in August with a $30 million Series A and a schizophrenia candidate called LTX-001 . → ADARx Pharmaceuticals has hopped aboard the banker-to-CFO train. The RNA startup poached Goldman Sachs healthcare investment banker Ryan Fisk , who will be chief financial and business officer at the San Diego biotech. Multiple other private drug developers have hired bankers to lead finance and help them go public. ADARx is a likely IPO candidate, since it’s already in Phase 3 with a hot drug modality, pharma validity with a major AbbVie pact , and backing from blue-chip investors like Bain Capital and TCGX . Fisk wrote to his LinkedIn following that he believes ADARx can be a “generational biotech company.” → For the third time this month , Peer Review is bringing you news of a Royalty Pharma hire. This time, decade-long IQVIA veteran Lucas Glass is becoming Royalty’s head of AI. “By incorporating intelligent automation, advanced analytics and AI-driven decision support, we are strengthening how we evaluate and invest in royalties and support our partners,” CEO Pablo Legorreta said in a statement . Glass was most recently SVP of technology at IQVIA. → Rani Therapeutics has selected ex- Radius Health chief Jesper Høiland as head of strategy. Høiland spent three decades at Novo Nordisk , and when Kelly Martin succeeded him at Radius Health, he became global chief commercial officer at Ascendis Pharma . He retired from Ascendis in 2022. → Mineralys Therapeutics has recruited Jeffrey Munsie as chief legal officer. Munsie previously held this position at two biotechs that have been acquired: Orbital Therapeutics (bought by Bristol Myers Squibb ) and Concert Pharmaceuticals (bought by Sun Pharma ). Will Mineralys be added to the list? Its aldosterone synthase inhibitor lorundrostat is showing promise in hypertension and has a Dec. 22 decision date with the FDA. → Atacicept maker Vera Therapeutics also has a new legal chief. Jane Wright-Mitchell spent more than two years with Vaxcyte as general counsel, chief compliance officer and corporate secretary, and she’s also worked on the legal teams at Mesoblast and Purdue Pharma . The FDA set a July 7 PDUFA date for atacicept in patients with IgA nephropathy. → Jennifer McDonough is getting started at Palvella Therapeutics as SVP of market access and patient services. McDonough was on the crew behind the commercial launch of the gene therapy Vyjuvek as SVP, patient access, analytics & operations at fellow Pennsylvania drugmaker Krystal Biotech . → Endpoints 11 winner Umoja Biopharma has welcomed Avenzo Therapeutics CEO Athena Countouriotis to the board of directors, along with Massachusetts General Hospital’s Marcela Maus . Countouriotis ran Turning Point Therapeutics until Bristol Myers scooped it up in 2022, and she’s also a board member at BioMarin , Iovance and Recludix Pharma , among others. → CAMP4 Therapeutics has elected Michael MacLean to the board of directors. MacLean is mapping out his next chapter after nearly six years as CFO of Avidity Biosciences , the RNA specialist that was sold to Novartis for $12 billion. → After retiring from Morgan Stanley in February, Jessica Chutter has joined the board of directors at PTC Therapeutics . Chutter had a 40-year career with Morgan Stanley, where she had been managing director and chair of biotechnology investment banking. Andrew Dunn also contributed to this edition.