{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:18:07Z","timestamp":1791494287994,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The efficacy and safety of lorundrostat, a selective aldosterone synthase inhibitor, in patients with uncontrolled hypertension remain unclear. This meta-analysis aimed to evaluate its effects on blood pressure and risk of hyperkalemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Cochrane Library, and ClinicalTrials.gov were systematically searched through July 2025 for randomized controlled trials comparing lorundrostat with placebo. Pooled mean differences (MD) and risk ratios (RR) with 95% CIs were estimated using a random-effects model with the Restricted Maximum Likelihood estimator. Trial sequential analysis (TSA) was conducted to assess the conclusiveness of safety evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three RCTs including 1060 patients were identified. Lorundrostat significantly reduced systolic blood pressure at 50 mg (MD, \u22129.08 mmHg; 95% CI, \u221213.14 to \u22125.03) and 100 mg (MD, \u221211.41 mmHg; 95% CI, \u221215.97 to \u22126.85), and diastolic blood pressure at 50 mg (MD, \u22123.48 mmHg; 95% CI, \u22125.98 to \u22120.98). However, lorundrostat increased the risk of hyperkalemia at 50 mg (RR, 6.56; 95% CI, 1.53-28.12; NNH\u2009=\u200971) and 100 mg (RR, 10.37; 95% CI, 2.44-44.03; NNH\u2009=\u200942). TSA confirmed hyperkalemia at 100 mg as the only conclusive harm signal, while other safety outcomes remained inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lorundrostat effectively lowered blood pressure but increased dose-dependent risk of hyperkalemia. These findings support its potential as a novel therapy for uncontrolled hypertension, while emphasizing the need for longer-term cardiovascular outcome trials and direct comparisons with mineralocorticoid receptor antagonists concerning efficacy and safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpaf246","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T12:55:13Z","timestamp":1766235313000},"page":"911-920","source":"Crossref","is-referenced-by-count":4,"title":["Lorundrostat for Patients With Uncontrolled Hypertension: A Systematic Review With Meta-Analysis and Trial Sequential Analysis"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5477-0112","authenticated-orcid":false,"given":"Vicente Morales","family":"Ribeiro","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Southern Santa Catarina , 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