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We investigated the efficacy and safety of a newly available nonsteroidal MR blocker, esaxerenone, in Japanese patients with hypertension and PA. A multicenter, open-label study was conducted in Japan between October 2016 and July 2017. Patients with hypertension and PA received 12 weeks of treatment with esaxerenone, initiated at 2.5\u2009mg\/day and escalated to 5\u2009mg\/day during week 2 or 4 of treatment, based on individual response. The only other permitted antihypertensive therapies were stable dosages of a Ca<jats:sup>2+<\/jats:sup> channel blocker or \u03b1-blocker. The primary efficacy outcome was a change in sitting systolic and diastolic blood pressure (SBP\/DBP) from baseline to the end of treatment. Forty-four patients were included; dose escalation to 5\u2009mg\/day was implemented for 41 of these patients. Significant decreases in SBP and DBP were observed (point estimates [95% confidence interval] \u221217.7 [\u221220.6, \u221214.7] and \u22129.5 [\u221211.7, \u22127.3] mmHg, respectively; both <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001 at the end of treatment). Significant BP reductions were evident from week 2 and continued through to week 8; BP remained stable until week 12. The antihypertensive effect of esaxerenone on SBP was significantly greater in females and in patients receiving monotherapy. The major drug-related adverse events were serum K<jats:sup>+<\/jats:sup> increase and estimated glomerular filtration rate decrease (both 4.5%, <jats:italic>n<\/jats:italic>\u2009=\u20092); no gynecomastia or breast pain was observed. We conclude that esaxerenone is a potent MR blocker with favorable efficacy and safety profiles in patients with hypertension and PA.<\/jats:p>","DOI":"10.1038\/s41440-020-00570-5","type":"journal-article","created":{"date-parts":[[2020,11,16]],"date-time":"2020-11-16T08:05:49Z","timestamp":1605513949000},"page":"464-472","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":56,"title":["Efficacy and safety of esaxerenone (CS-3150), a newly available nonsteroidal mineralocorticoid receptor blocker, in hypertensive patients with primary aldosteronism"],"prefix":"10.1038","volume":"44","author":[{"given":"Fumitoshi","family":"Satoh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadayoshi","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Itoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Rakugi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsuhiro","family":"Ichihara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masao","family":"Omura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsutoshi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Okuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setsuko","family":"Iijima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,11,16]]},"reference":[{"key":"570_CR1","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1016\/j.jacc.2006.07.059","volume":"48","author":"GP Rossi","year":"2006","unstructured":"Rossi GP, Bernini G, Caliumi C, Desideri G, Fabris B, Ferri C, et al. 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YO and SI are employees of Daiichi Sankyo Co., Ltd. FS, HS, AI, MO, and KT have no conflicts of interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}