HypertensionRandomised controlled trial

Efficacy of Tonlamarsen in Patients With Uncontrolled Hypertension

J Am Coll CardiolPublished

  • Randomised controlled trial
  • placebo-controlled
  • 4-week placebo lead-in
  • 4-week active run-in

Authors' conclusion

Among individuals with uncontrolled hypertension, monthly tonlamarsen administration was more effective at lowering plasma angiotensinogen compared with a single tonlamarsen dose, but there was no additional BP reduction.

Study context

Population
Adults with uncontrolled hypertension: office SBP >135 mm Hg on 2 to 5 antihypertensive medicationsrandomized
Participants
198 adults
Comparison
Monthly tonlamarsen vs single dose of tonlamarsen and subsequent placebo
Primary endpoint
Coprimary: between-group differences in change from baseline in plasma angiotensinogen and in office SBP
Follow-up
Week 20

Primary result

As reported in the abstract

20 weeks after first dose

Single dose then placebo

−23.0% (95% CI: −27.8% to −18.2%)

Plasma angiotensinogen % change · Office SBP change −6.7 mm Hg (95% CI: −9.8 to −3.5 mm Hg)

Monthly tonlamarsen

−67.2% (95% CI: −71.9% to −62.4%)

Plasma angiotensinogen % change · Office SBP change −6.7 mm Hg (95% CI: −9.8 to −3.6 mm Hg)

Monthly tonlamarsen vs Single dose then placeboLS mean difference, % (97.5% CI)P value
plasma angiotensinogen
−44.1(−51.9% to −36.4%)
P < 0.0001
office SBP
Least squares (LS) mean difference −0.1 mm Hg (95% CI −4.5 to −4.4 mm Hg); P = 0.97

Safety

Serious adverse events

Infrequent and similar between treatment groups

Original publication

Efficacy of Tonlamarsen in Patients With Uncontrolled Hypertension. J Am Coll Cardiol. Published 28 March 2026. doi:10.1016/j.jacc.2026.03.034

Summarised from the published abstract; every number is checked against it