AstraZeneca's Baxdrostat Shows Promise in Phase 3 Hypertension Trial

AstraZeneca's aldosterone synthase inhibitor baxdrostat has demonstrated significant efficacy in reducing blood pressure among patients with treatment-resistant hypertension, according to data presented at the American Heart Association 2025 Scientific Sessions. The phase 3 Bax24 trial results mark a crucial milestone for the pharmaceutical giant's $1.3 billion investment in CinCor Pharma, the original developer of baxdrostat.

Impressive Blood Pressure Reductions

The Bax24 trial, which enrolled 218 patients with treatment-resistant hypertension, showed that baxdrostat reduced ambulatory 24-hour average systolic blood pressure (SBP) by 14 mmHg compared to placebo over a 12-week period. This placebo-adjusted reduction is notably higher than the 7.9 mmHg drop reported for Mineralys Therapeutics' rival drug lorundrostat in similar trials.

Secondary endpoints also yielded positive results, with baxdrostat demonstrating statistically significant and clinically meaningful reductions in ambulatory nighttime average SBP (13.9 mmHg) and seated SBP (10.3 mmHg).

Competitive Advantage and Market Potential

Baxdrostat's extended half-life of 26 to 30 hours, compared to lorundrostat's 10 to 12 hours, is believed to be a key factor in its superior performance. This characteristic could provide AstraZeneca with a significant competitive edge in the hypertension market.

Sharon Barr, Executive Vice President of Biopharmaceuticals R&D at AstraZeneca, emphasized the drug's potential impact: "The Bax24 data demonstrate the significant impact that baxdrostat's long half-life and highly selective inhibition of aldosterone synthase can have in improving 24-hour and overnight blood pressure for patients with resistant hypertension."

Regulatory Path and Future Outlook

AstraZeneca has confirmed its intention to share the Bax24 trial data with regulatory authorities worldwide, although no specific timeline for approval submissions has been disclosed. The success of baxdrostat is crucial to AstraZeneca's ambitious plans to grow sales to $80 billion by 2030.

As the pharmaceutical landscape evolves, baxdrostat is poised to face competition from Mineralys Therapeutics' lorundrostat, which is also progressing through late-stage clinical development. The race to market between these two aldosterone synthase inhibitors could reshape the treatment paradigm for resistant hypertension in the coming years.