Aprocitentan, a Newly Approved Drug for Resistant Hypertension

On March 19, 2024, the U.S. Food and Drug Administration (FDA) approved aprocitentan (Tryvio), a new drug for treating patients with resistant hypertension.1

Background

As an endothelin-receptor antagonist, the drug blocks the activity of endothelin-1, a vasoconstrictor that is secreted by endothelial cells. According to the manufacturer, aprocitentan is the first oral drug with a novel mechanism of action to be approved to manage systemic hypertension in decades. (Note: several drugs in this class previously have been approved for managing pulmonary hypertension).

The randomized trial that led to FDA approval

In 2022, NEJM Journal Watch covered the pivotal trial that resulted in aprocitentan's FDA approval (NEJM JW Cardiol Dec 15 2022; [e-pub]…