Esaxerenone +/– SGLT2i in Hypertensive T2DM Patients
Esaxerenone +/– SGLT2i in Hypertensive T2DM Patients
Source: Hypertension News – International Society of Hypertension, December 2025
Keynotes :
• Study type: pooled analysis of 5 prospective clinical studies (≈280 patients).
• Drug: Esaxerenone — a nonsteroidal mineralocorticoid receptor blocker (MRB).
• Population: Hypertensive patients with type 2 diabetes — with and without SGLT2 inhibitor therapy.
1. Blood Pressure Reduction
• Significant BP drop by week 12 in all groups.
• Overall: −11.9 / −5.2 mmHg
• With SGLT2i: −11.3 / −4.8 mmHg
• Without SGLT2i: −12.5 / −5.7 mmHg
• ~70% achieved home BP target <135/85 mmHg.
2. Kidney & Cardiac Effects
• Albuminuria (UACR) improved by ~43% in all groups.
• NT-proBNP improved regardless of SGLT2i use.
3. Safety
• Mild rise in serum potassium at week 2 → stabilized by week 12.
• Hyperkalemia ≥5.5 mEq/L:
• 2.0% with SGLT2i
• 5.2% without SGLT2i
→ SGLT2 inhibitors may reduce hyperkalemia risk.
4. Clinical Interpretation
• Esaxerenone is effective with or without SGLT2 inhibitors.
• Combined use appears safe with complementary mechanisms (natriuresis + MR blockade).
• Esaxerenone preferred over finerenone when both hypertension control and albuminuria reduction are needed.
Bottom Line
Esaxerenone provides strong BP lowering, improves albuminuria and cardiac markers, and maintains a favorable safety profile—showing even lower potassium risk when combined with SGLT2 inhibitors.
🔗 Full Article: https://ish-world.com/document/1764854170.pdf
