NCT07686120

Brief Summary

This is a Phase IIIb, multicentre, randomised, double-blind, placebo-controlled, parallel group study to evaluate the effect of baxdrostat 2mg versus placebo, administered QD orally, on the reduction of ambulatory 24-hour average SBP in participants with uHTN. Consenting participants will be screened within 4 weeks and will subsequently enter a 4-week run-in period with placebo. Thereafter, participants will be randomised in a 1:1 ratio to receive one of the following 2 treatments QD, during a 12-week double-blind treatment period: baxdrostat 2mg Placebo The randomisation will be stratified by mean ambulatory SBP at baseline (\<140 mmHg, ≥140 mmHg) and the number of background antihypertensive medication classes (2, ≥3) at baseline. During the 12-week double-blind treatment period, participants should remain on their background antihypertensive medication. Doses of background medications should not be changed during this period unless participants experience SBP \< 100 mmHg with symptoms of hypotension. Rescue therapy is permitted if the SBP or DBP exceeds 170 or 105 mmHg, respectively. The choice of rescue therapy is based on the Investigator's best clinical judgement; however, the use of potassium-sparing diuretics and MRAs are prohibited.After completing the 12 weeks double-blind treatment period participants will complete a 2-week safety follow-up period. The total duration of study participation will be of approximately 22 weeks.

Trial Health

65
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
286

participants targeted

Target at P50-P75 for phase_3

Timeline
17mo left

Started Sep 2026

Status
not yet recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

May 22, 2026

Completed
2 months until next milestone

First Posted

Study publicly available on registry

July 7, 2026

Completed
3 months until next milestone

Study Start

First participant enrolled

September 30, 2026

Expected
1.4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 9, 2028

Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 9, 2028

Last Updated

July 7, 2026

Status Verified

June 1, 2026

Enrollment Period

1.4 years

First QC Date

May 22, 2026

Last Update Submit

July 1, 2026

Conditions

Keywords

Uncontrolled Hypertension

Outcome Measures

Primary Outcomes (1)

  • Change from baseline in ambulatory 24-hour average Systolic blood pressure(SBP) at Week 12

    To assess the effect of baxdrostat 2mg versus placebo on ambulatory 24-hour average SBP at 12 weeks

    Week12

Secondary Outcomes (13)

  • Change from baseline in ambulatory night-time average Systolic blood pressure(SBP) at Week 12

    week12

  • Change from baseline in ambulatory daytime average Systolic blood pressure(SBP) at Week 12

    week12

  • Change from baseline in seated Systolic blood pressure(SBP) at Week 12

    week12

  • Percentage achieving ambulatory 24-hour average SBP <130 mmHg at Week 12

    week12

  • Change from baseline in ambulatory 24-hour Diastolic Blood Pressure(DBP) at Week 12

    week12

  • +8 more secondary outcomes

Study Arms (2)

baxdrostat 2 mg

EXPERIMENTAL

2 mg baxdrostat administered orally, once daily (QD)

Drug: baxdrostat 2mg

Placebo 2mg

PLACEBO COMPARATOR

2 mg placebo administered orally, once daily (QD)

Drug: Placebo 2mg

Interventions

baxdrostat 2mg tablet administered orally, once daily (QD).

baxdrostat 2 mg

Placebo 2mg tablet administered orally, once daily (QD).

Placebo 2mg

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants are eligible to be included in the study only if all of the following criteria apply:
  • Age 1. Participant must be ≥18 years old, at the time of signing the informed consent.
  • Type of Participant and Disease Characteristics
  • Mean seated SBP on AOBPM ≥140 mmHg and \<170 mmHg at screening. Seated BP will be measured using standardised automated BP machines and using standardised procedures.
  • Have a stable regimen (≥ 4 weeks before the screening visit) of ≥ 2 antihypertensive medications, from different therapeutic classes (should not be a diuretic), at full doses per guidelines or maximum tolerated doses in the judgement of the Investigator, for at least 4 weeks prior to screening (participants who do not meet this criterion may be rescreened at the Investigator's discretion. Beta blockers used to treat other conditions (i.e., migraine, heart failure \[HF\], coronary artery disease) should not be counted as an antihypertensive medication for the purpose of qualifying for this study.
  • Have eGFR ≥45 mL/min/1.73m2 at screening.
  • Serum potassium (K+) level ≥3.5 and \<5.0 mmol/L at screening, determined as per central laboratory.
  • Sex and Contraceptive/Barrier Requirements
  • Only female participants:
  • Contraceptive use by females should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
  • a) Female participants: i. Females not of childbearing potential are defined as females who are either permanently sterilised (hysterectomy, bilateral oophorectomy, or bilateral salpingectomy), or who are postmenopausal. Females will be considered postmenopausal if they have been amenorrhoeic for 12 months prior to the planned date of randomisation without an alternative medical cause. The following age specific requirements apply:
  • Women \<50 years old would be considered postmenopausal if they have been amenorrhoeic for 12 months or more following cessation of exogenous hormonal treatment and follicle-stimulating hormone levels within the postmenopausal range.
  • Women ≥50 years old would be considered postmenopausal if they have been amenorrhoeic for 12 months or more following cessation of all exogenous hormonal treatment ii. Female participants of child-bearing potential must use one highly effective form of birth control. A highly effective method of contraception is defined as one that can achieve a failure rate of less than 1% per year when used consistently and correctly. Females of child-bearing potential who are sexually active with a non-sterilised male partner must agree to use one highly effective method of birth control, as defined below, from 30 days before enrolment and throughout the study, and until at least 30 days after last dose of study intervention. Cessation of contraception after this point should be discussed with a responsible physician.
  • iii. The following are not acceptable methods of contraception: periodic abstinence (calendar, symptom-thermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only and lactational amenorrhoea. Female condom and male condom should not be used together.
  • iv. All females of child-bearing potential must have a negative pregnancy test result at screening and not be at stage of breastfeeding v. Highly effective birth control methods include: Total sexual abstinence is an acceptable method provided it is the usual lifestyle of the participant (defined as refraining from heterosexual intercourse during the entire period of risk associated with the study treatments) (\[periodic abstinence - e.g., calendar, ovulation, sympto-thermal, post-ovulation methods - declaration of abstinence for the duration of exposure to study intervention and withdrawal are not acceptable methods of contraception\]); a vasectomised partner; subdermal contraceptive implants; bilateral tubal occlusion; intrauterine device/levonorgestrel intrauterine system; injectable contraceptive; oral contraceptive associated with inhibition of ovulation; and contraceptive transdermal patch, or vaginal ring.
  • +8 more criteria

You may not qualify if:

  • Participants are excluded from the study if any of the following criteria apply:
  • Medical Conditions
  • As judged by the investigator, any evidence of which in the investigator's opinion makes it undesirable for the participant to participate in the study.
  • Mean seated SBP on AOBPM ≥170 mmHg (participants who do not meet this criterion may be rescreened at the Investigator's discretion, see Section 5.4.2 for rescreening criteria and Section 8.2.1 for BP measurement procedures).
  • Mean seated DBP on AOBPM ≥110 mmHg (participants who do not meet this criterion may be rescreened at the Investigator's discretion).
  • Serum sodium level (Na+) \<135 mmol/L at screening, determined as per central laboratory.
  • Has the following known secondary causes of hypertension: renal artery stenosis, uncontrolled or untreated hyperthyroidism, uncontrolled or untreated hypothyroidism, pheochromocytoma, Cushing's syndrome, aortic coarctation.
  • New York Heart Association functional HF class IV at Screening.
  • Medical history of stroke, acute coronary syndrome, hypertensive encephalopathy, or hospitalization for HF within 6 months prior to Screening.
  • Planned percutaneous coronary intervention/coronary artery bypass grafting or percutaneous coronary intervention/coronary artery bypass grafting done within 6 months prior to screening.
  • Known current severe left ventricular outflow obstruction, such as obstructive hypertrophic cardiomyopathy and/or severe aortic valvular disease.
  • Known severe hepatic impairment, defined as Child-Pugh Class C, based on records that confirm documented medical history.
  • Uncontrolled diabetes with HbA1c \>10.0% (86 mmol/mol) at Screening.
  • Participants suspected to have severe cardiac hypertrophy.
  • Participants who are pregnant or breastfeeding. Prior/Concomitant Therapy
  • +10 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Central Study Contacts

AstraZeneca Clinical Study Information Center

CONTACT

Study Design

Study Type
interventional
Phase
phase 3
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Consenting participants will be screened within 4 weeks and will subsequently enter a 4-week run-in period with placebo. Thereafter, participants will be randomised in a 1:1 ratio to receive one of the following 2 treatments QD, during a 12-week double-blind treatment period: baxdrostat 2mg Placebo The randomisation will be stratified by mean ambulatory SBP at baseline (\<140 mmHg, ≥140 mmHg) and the number of background antihypertensive medication classes (2, ≥3) at baseline.
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

May 22, 2026

First Posted

July 7, 2026

Study Start (Estimated)

September 30, 2026

Primary Completion (Estimated)

February 9, 2028

Study Completion (Estimated)

February 9, 2028

Last Updated

July 7, 2026

Record last verified: 2026-06