ACC.24 — We are joined onsite by investigator, Dr Akshay Desai (Brigham and Women's Hospital, US) to discuss the findings from the KARDIA-2 randomized clinical trial (NCT05103332).

KARDIA-2 is a double-blind, placebo-controlled multicenter study aiming to evaluate the effects of zilebesiran, an RNA interference agent, on the systolic and diastolic blood pressure of hypertensive patients not adequately controlled by a standard-of-care antihypertensive medication.

672 patients were enrolled in the study, who were randomized to receive treatment with either indapamide 2.5mg daily, amlodopine 5mg daily or olmesartan 40mg daily. After a run-in period, these arms were then again randomized to recieve either zilebesiran 600mg SC or placebo, in addition to indapamide, amlodopine or olmesartan.

Findings showed that treatment with a single subcutaneous dose of zilebesiran 600mg was associated with clinically significant reductions in 24 hour mean ambulatory and office systolic blood pressure compared with placebo at 3 months, when added to a diuretic, calcium channel blocker or maximum-dose angiotensin receptor blocker. This difference was sustained to 6 months in the indapamide and amlodipine cohorts despite add-on hypertensive therapy.

Interview questions:
1. What is the importance of this study?
2. Why is this drug needed?
3. What is the patient population and study design?
4. What are your key findings?
5. What are the clinical implications of these findings?
6. What remaining questions will KARDIA-3 answer?

Recorded onsite at the ACC Conference in Atlanta, 2024.

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Support: This is an independent interview conducted by Radcliffe Cardiology.

Editors: Jordan Rance, Mirjam Boros

Video Specialists: Dan Brent, Tom Green, Mike Knight