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AzTrials

HypertensionPhase 2KARDIA-2NCT05103332

Zilebesiran as Add-on Therapy in Patients With Hypertension Not Adequately Controlled by a Standard of Care Antihypertensive Medication (KARDIA-2)

A Phase 2 study testing Indapamide, Amlodipine and Olmesartan in people with Hypertension, run by Alnylam Pharmaceuticals at 110 sites in 8 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record

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Trial summary

The purpose of this study is to evaluate the effect of zilebesiran on systolic and diastolic blood pressure and to characterize the pharmacodynamic (PD) effects and safety of zilebesiran as add-on therapy. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Hypertension
What is being tested?
Indapamide, Amlodipine and Olmesartan
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
663 participants
Where
110 sitesin 8 countries
Study dates
5 Nov 2021to 13 Sep 2024
Phase
Phase 2

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Office SBP at Screening as follows:
  • ≥155 mmHg and ≤180 mmHg for patients with untreated hypertension
  • ≥145 mmHg and ≤180 mmHg for patients on antihypertensive medications
  • 24-hour mean SBP ≥130 mmHg and ≤160 mmHg by ABPM after at least 4 weeks of run-in

Who cannot join

  • Secondary hypertension, orthostatic hypotension
  • Elevated potassium <lower limit of normal (LLN) range or >5 milliequivalents per liter (mEq/L)
  • Estimated glomerular filtration rate (eGFR) of <30 mL/min/1.73m^2
  • Received an investigational agent within the last 30 days
  • Type 1 diabetes mellitus, poorly controlled Type 2 diabetes mellitus, or laboratory evidence of diabetes during screening without known diagnosis of diabetes
  • History of any cardiovascular event within 6 months prior to randomization
  • History of intolerance to SC injection(s)

Trial locations and contacts

110 sites in 8 countries.

110 sites in 8 countries

United States74 sites
  • Clinical Trial Site

    Acworth, Georgia, 30101

  • Clinical Trial Site

    Amarillo, Texas, 79109

  • Clinical Trial Site

    Bell Gardens, California, 90201

  • Clinical Trials Site

    Beverly Hills, California, 90211

  • Clinical Trial Site

    Burke, Virginia, 22015

  • Clinical Trial Site

    Canoga Park, California, 91304

  • Clinical Trial Site

    Canton, Georgia, 30114

  • Clinical Trial Site

    Carlsbad, California, 92008

  • Clinical Trial Site

    Clearwater, Florida, 33756

  • Clinical Trial Site

    Coconut Creek, Florida, 33073

  • Clinical Trial Site

    Columbus, Georgia, 31904

  • Clinical Trial Site

    Coppell, Texas, 75019

  • Clinical Trial Site

    Coral Gables, Florida, 33134

  • Clinical Trial Site

    Dallas, Texas, 75251

  • Clinical Trial Site

    Encinitas, California, 92024

  • Clinical Trial Site

    Garden Grove, California, 92844

  • Clinical Trial Site

    Greensboro, North Carolina, 27403

  • Clinical Trial Site

    Greensboro, North Carolina, 27410

  • Clinical Trial Site

    Hazelwood, Missouri, 63042

  • Clinical Trial Site

    Hollywood, California, 91606

  • Clinical Trial Site

    Hollywood, Florida, 33021

  • Clinical Trial Site

    Hollywood, Florida, 33024

  • Clinical Trial Site

    Houston, Texas, 77074

  • Clinical Trial Site

    Houston, Texas, 77081

  • Clinical Trial Site

    Huntington Beach, California, 92647

  • Clinical Trial Site

    Inverness, Florida, 34452

  • Clinical Trial Site

    Irvine, California, 92614

  • Clinical Trial Site

    Jackson, Mississippi, 39209

  • Clinical Trial Site

    Jacksonville, Florida, 32256

  • Clinical Trial Site

    Jefferson City, Missouri, 65109

  • Clinical Trial Site

    Kenosha, Wisconsin, 53142

  • Clinical Trial Site

    Lake Jackson, Texas, 77566

  • Clinical Trial Site

    Little River, South Carolina, 29566

  • Clinical Trial Site

    Long Beach, California, 90805

  • Clinical Trial Site

    Los Angeles, California, 90057

  • Clinical Trial Site

    Louisville, Kentucky, 40202

  • Clinical Trial Site

    Memphis, Tennessee, 38119

  • Clinical Trial Site

    Mesa, Arizona, 85213

  • Clinical Trial Site

    Miami, Florida, 33032

  • Clinical Trial Site

    Miami, Florida, 33125

  • Clinical Trial Site

    Miami, Florida, 33135

  • Clinical Trial Site

    Miami, Florida, 33144

  • Clinical Trial Site

    Miami, Florida, 33176

  • Clinical Trial Site

    Mission Hills, California, 91345

  • Clinical Trial Site

    Monroe, North Carolina, 28112

  • Clinical Trial Site

    Naples, Florida, 34105

  • Clinical Trial Site

    New Orleans, Louisiana, 70769

  • Clinical Trial Site

    New York, New York, 10036

  • Clinical Trial Site

    Norman, Oklahoma, 73072

  • Clinical Trial Site

    Oceanside, California, 92056

  • Clinical Trial Site

    Orlando, Florida, 32162

  • Clinical Trial Site

    Orlando, Florida, 32801

  • Clinical Trial Site

    Panorama City, California, 91402

  • Clinical Trial Site

    Pembroke Pines, Florida, 33027

  • Clinical Trial Site

    Plano, Texas, 75024

  • Clinical Trial Site

    San Diego, California, 92103

  • Clinical Trial Site

    Santa Clarita, California, 91355

  • Clinical Trial Site

    Savannah, Georgia, 31406

  • Clinical Trial Site

    Sherman, Texas, 75092

  • Clinical Trial Site

    South Gate, California, 90280

  • Clinical Trial Site

    Southgate, Michigan, 48195

  • Clinical Trial Site

    Splendora, Texas, 77372

  • Clinical Trial Site

    Stephenville, Texas, 76401

  • Clinical Trial Site

    Tampa, Florida, 33603

  • Clinical Trial Site

    Tempe, Arizona, 85281

  • Clinical Trial Site

    Tempe, Arizona, 85282

  • Clinical Trial Site

    Tomball, Texas, 77375

  • Clinical Trial Site

    Tustin, California, 92780

  • Clinical Trial Site

    Upland, California, 91786

  • Clinical Trial Site

    Waco, Texas, 76708

  • Clinical Trial Site

    Washington D.C., District of Columbia, 20011

  • Clinical Trial site

    Winston-Salem, North Carolina, 27157

  • Clinical Trial Site

    Winter Haven, Florida, 33880

  • Clinical Trial Site

    Winter Park, Florida, 32789

Other trials in United States

United Kingdom13 sites
  • Clinical Trial Site

    Bellshill, Lanarkshire, ML4 3NJ

  • Clinical Trial Site

    Carshalton

  • Clinical Trial Site

    Edinburgh

  • Clinical Trial Site

    Fowey

  • Clinical Trial Site

    Glasgow

  • Clinical Trial Site

    Lancashire Preston

  • Clinical Trial Site

    Liskeard

  • Clinical Trial Site

    London

  • Clinical Trial Site

    Manchester

  • Clinical Trial Site

    Newquay

  • Clinical Trial Site

    Plymouth

  • Clinical Trial Site

    Sheffield

  • Clinical Trial Site

    Torpoint

Other trials in United Kingdom

Canada12 sites
  • Clinical Trial Site

    Brampton, Ontario

  • Clinical Trial Site

    Chicoutimi, Quebec

  • Clinical Trial Site

    Concord, Ontario

  • Clinical Trial Site

    Lévis, Quebec

  • Clinical Trial Site

    London, Ontario, N5W 6A2

  • Clinical Trial Site

    Pointe-Claire, Quebec

  • Clinical Trial Site

    Québec, Quebec

  • Clinical Trial Site

    Québec

  • Clinical Trial Site

    Sherbrooke, Quebec

  • Clinical Trial Site

    Toronto, Ontario

  • Clinical Trial Site

    Trois-Rivières, Quebec

  • Clinical Trial Site

    Winnipeg, Ontario

Other trials in Canada

Poland6 sites
  • Clinical Trial Site

    Częstochowa

  • Clinical Trial Site

    Gdansk

  • Clinical Trial Site

    Katowice

  • Clinical Trial Site

    Staszów

  • Clinical Trial Site

    Warsaw

  • Clinical Trial Site

    Wroclaw

Other trials in Poland

Lithuania2 sites
  • Clinical Trial Site

    Kaunas

  • Clinical Trial Site

    Vilnius

Other trials in Lithuania

Estonia1 site
  • Clinical Trial Site

    Tartu

Other trials in Estonia

Germany1 site
  • Clinical Trial Site

    Frankfurt

Other trials in Germany

Latvia1 site
  • Clinical Trial Site

    Riga

Other trials in Latvia

About this study

Official title: A Randomized, Double-blind, Placebo-controlled, Multicenter Study to Evaluate the Efficacy and Safety of Zilebesiran Used as Add-on Therapy in Patients With Hypertension Not Adequately Controlled by a Standard of Care Antihypertensive Medication

The purpose of this study is to evaluate the effect of zilebesiran on systolic and diastolic blood pressure and to characterize the pharmacodynamic (PD) effects and safety of zilebesiran as add-on therapy.

Conditions
Hypertension
Being tested
Indapamide, Amlodipine, Olmesartan, Placebo, Zilebesiran
Keywords
High blood pressure, Hypertension, Hypertensive, siRNA, Angiotensinogen, AGT
Medical subject headings
Hypertension

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • IndapamideDrug

    Indapamide administered orally

  • AmlodipineDrug

    Amlodipine administered orally

  • OlmesartanDrug

    Olmesartan administered orally

  • PlaceboDrug

    Placebo administered by SC injection

  • ZilebesiranDrug

    Also called ALN-AGT01

    Zilebesiran administered by SC injection

Study groups in NCT05103332
Study groupRoleWhat they receive
Placebo (Add-on to Indapamide)Placebo comparatorFollowing a 4-week run-in treatment on indapamide, 2.5 milligrams (mg), orally, once daily (QD), eligible participants were randomized to receive placebo matched to zilebesiran as a subcutaneous (SC) injection on Day 1 of 6-month double-blind (DB) treatment period as add-on therapy to indapamide. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran once every 6 months (Q6M) during the open-label extension (OLE) period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Indapamide; Drug: Placebo; Drug: Zilebesiran
Zilebesiran (Add-on to Indapamide)ExperimentalFollowing a 4-week run-in treatment on indapamide, 2.5 mg, orally, QD, eligible participants were randomized to receive zilebesiran 600 mg, as a SC injection on Day 1 of 6-month DB treatment period as add-on therapy to indapamide. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran, Q6M during the OLE period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Indapamide; Drug: Zilebesiran
Placebo (Add-on to Amlodipine)Placebo comparatorFollowing a 4-week run-in treatment on amlodipine, 5 mg, orally, QD, eligible participants were randomized to receive placebo matched to zilebesiran as a SC injection on Day 1 of 6-month DB treatment period as add-on therapy to amlodipine. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran Q6M during the OLE period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Amlodipine; Drug: Placebo; Drug: Zilebesiran
Zilebesiran (Add-on to Amlodipine)ExperimentalFollowing a 4-week run-in treatment on amlodipine, 5 mg, orally, QD, eligible participants were randomized to receive zilebesiran 600 mg, as a SC injection on Day 1 of 6-month DB treatment period as add-on therapy to amlodipine. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran, Q6M during the OLE period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Amlodipine; Drug: Zilebesiran
Placebo (Add-on to Olmesartan)Placebo comparatorFollowing a 4-week run-in treatment on olmesartan, 40 mg, orally, QD, (or 20 mg, orally, QD for participants with creatinine clearance ≤60 milliliters per minute [mL/min] at screening enrolled at sites outside of the United States [US] consistent with local labeling), eligible participants were randomized to receive placebo matched to zilebesiran as a SC injection on Day 1 of 6-month DB treatment period as add-on therapy to olmesartan. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran Q6M during the OLE period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Olmesartan; Drug: Placebo; Drug: Zilebesiran
Zilebesiran (Add-on to Olmesartan)ExperimentalFollowing a 4-week run-in treatment on olmesartan, 40 mg, orally, QD, (or 20 mg, orally, QD for participants with creatinine clearance ≤60 mL/min at screening enrolled at sites outside of the US consistent with local labeling), eligible participants were randomized to receive zilebesiran 600 mg, as a SC injection on Day 1 of 6-month DB treatment period as add-on therapy to olmesartan. Participants received protocol-assigned background medication for 6 months, after which it was discontinued. Thereafter, participants will receive zilebesiran, Q6M during the OLE period. Upon implementation of Amendment 3, the OLE period was closed.
Receives: Drug: Olmesartan; Drug: Zilebesiran

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Indapamide: Change From Baseline at Month 3 in 24-hour Mean SBP Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during day (6 am- 9:59 pm) and every 30 minutes during night (10 pm-5:59 am). ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e.,3 sections of 60 minutes where 0 valid readings were obtained). To summarize 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was the average of the hourly means. Least squares (LS) mean and standard error (SE) were calculated using a mixed model repeated measures (MMRM) approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  2. Amlodipine: Change From Baseline at Month 3 in 24-hour Mean SBP Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during day (6 am- 9:59 pm) and every 30 minutes during night (10 pm-5:59 am). ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e.,3 sections of 60 minutes where 0 valid readings were obtained). To summarize 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was the average of the hourly means. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  3. Olmesartan: Change From Baseline at Month 3 in 24-hour Mean SBP Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during day (6 am- 9:59 pm) and every 30 minutes during night (10 pm-5:59 am). ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e.,3 sections of 60 minutes where 0 valid readings were obtained). To summarize 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

Secondary outcomes (42)
  1. Indapamide: Change From Baseline at Month 3 in Office SBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP assessed while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  2. Indapamide: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean SBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the area under the curve (AUC) of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  3. Indapamide: Time-adjusted Change From Baseline Through Month 6 in Office SBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  4. Indapamide: Percentage of Participants With 24-hour Mean SBP <130 mmHg and/or Reduction From Baseline ≥20 mmHg Assessed by ABPM Without Escape Antihypertensive Medications at Month 6

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average of BP for each hour of the day. The 24-hour mean was average of the hourly means.

    Measured: Month 6

  5. Indapamide: Change From Baseline at Month 3 in 24-hour Mean Diastolic Blood Pressure (DBP), Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for DBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  6. Indapamide: Change From Baseline at Month 3 in Office DBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office DBP assessed while participants were on and within 2 weeks after stopping any escape medication was censored for this endpoint.

    Measured: Baseline and Month 3

  7. Indapamide: Time-adjusted Change From Baseline Through Month 3 in 24-hour Mean SBP and DBP, Assessed by ABPM - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP and DBP, assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline through Month 3

  8. Indapamide: Time-adjusted Change From Baseline in Office SBP and DBP Through Month 3 - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP and DBP, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline through Month 3

  9. Indapamide: Change From Baseline at Month 6 in 24-hour Mean SBP and DBP, Assessed by ABPM - All Collected Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP and DBP assessed by ABPM are included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  10. Indapamide: Change From Baseline at Month 6 in Office SBP and DBP - All Collected Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP and DBP, were included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  11. Indapamide: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean DBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for DBP assessed by ABPM were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  12. Indapamide: Time-adjusted Change From Baseline Through Month 6 in Office DBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office DBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  13. Indapamide: Change From Baseline in Daytime and Nighttime SBP and DBP by ABPM at Each Visit - All Collected Data

    ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; and 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for daytime and nighttime SBP and DBP, assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline, and Month 2, 3 and 6

  14. Indapamide: Percent Change From Baseline in Serum Angiotensinogen (AGT)

    Measured: Baseline, Week 2 and Months 1, 2, 3, 4, 5 and 6

  15. Amlodipine: Change From Baseline at Month 3 in Office SBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP assessed while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  16. Amlodipine: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean SBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  17. Amlodipine: Time-adjusted Change From Baseline Through Month 6 in Office SBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  18. Amlodipine: Percentage of Participants With 24-hour Mean SBP <130 mmHg and/or Reduction From Baseline ≥20 mmHg Assessed by ABPM Without Escape Antihypertensive Medications at Month 6

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average of BP for each hour of the day. The 24-hour mean was average of the hourly means.

    Measured: Month 6

  19. Amlodipine: Change From Baseline at Month 3 in 24-hour Mean DBP, Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for DBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  20. Amlodipine: Change From Baseline at Month 3 in Office DBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office DBP assessed while participants were on and within 2 weeks after stopping any escape medication was censored for this endpoint.

    Measured: Baseline and Month 3

  21. Amlodipine: Time-adjusted Change From Baseline Through Month 3 in 24-hour Mean SBP and DBP, Assessed by ABPM - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP and DBP, assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline through Month 3

  22. Amlodipine: Time-adjusted Change From Baseline in Office SBP and DBP Through Month 3 - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP and DBP, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline through Month 3

  23. Amlodipine: Change From Baseline at Month 6 in 24-hour Mean SBP and DBP, Assessed by ABPM - All Collected Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP and DBP assessed by ABPM are included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  24. Amlodipine: Change From Baseline at Month 6 in Office SBP and DBP - All Collected Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP and DBP, were included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  25. Amlodipine: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean DBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for DBP assessed by ABPM were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  26. Amlodipine: Time-adjusted Change From Baseline Through Month 6 in Office DBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office DBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  27. Amlodipine: Change From Baseline in Daytime and Nighttime SBP and DBP by ABPM at Each Visit - All Collected Data

    ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; and 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for daytime and nighttime SBP and DBP, assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline, and Month 2, 3 and 6

  28. Amlodipine: Percent Change From Baseline in Serum AGT

    Measured: Baseline, Week 2 and Months 1, 2, 3, 4, 5 and 6

  29. Olmesartan: Change From Baseline at Month 3 in Office SBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP assessed while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  30. Olmesartan: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean SBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  31. Olmesartan: Time-adjusted Change From Baseline Through Month 6 in Office SBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  32. Olmesartan: Percentage of Participants With 24-hour Mean SBP <130 mmHg and/or Reduction From Baseline ≥20 mmHg Assessed by ABPM Without Escape Antihypertensive Medications at Month 6

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average of BP for each hour of the day. The 24-hour mean was average of the hourly means.

    Measured: Month 6

  33. Olmesartan: Change From Baseline at Month 3 in 24-hour Mean DBP, Assessed by ABPM - Censored Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for DBP assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline and Month 3

  34. Olmesartan: Change From Baseline at Month 3 in Office DBP - Censored Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office DBP assessed while participants were on and within 2 weeks after stopping any escape medication was censored for this endpoint.

    Measured: Baseline and Month 3

  35. Olmesartan: Time-adjusted Change From Baseline Through Month 3 in 24-hour Mean SBP and DBP, Assessed by ABPM - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for SBP and DBP, assessed using ABPM, while participants were on and within 2 weeks after stopping any escape medication were censored for this endpoint.

    Measured: Baseline through Month 3

  36. Olmesartan: Time-adjusted Change From Baseline in Office SBP and DBP Through Month 3 - Censored Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Hypothetical strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., data for office SBP and DBP, while participants were on and within 2 weeks after stopping any escape medication was censored for this endpoint.

    Measured: Baseline through Month 3

  37. Olmesartan: Change From Baseline at Month 6 in 24-hour Mean SBP and DBP, Assessed by ABPM - All Collected Data

    24-hour ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). To summarize the 24-hour ABPM, the hourly adjusted mean was calculated. Hourly adjusted mean was the average BP for each hour of the day. The 24-hour mean was average of the hourly means. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for SBP and DBP assessed by ABPM are included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  38. Olmesartan: Change From Baseline at Month 6 in Office SBP and DBP - All Collected Data

    The mean office BP in the sitting position was used for the analysis. Office BP in the sitting position was collected with a set of 4 replicates. The average of the last 3 replicates was calculated and used for analysis. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office SBP and DBP, were included in the analysis for this endpoint.

    Measured: Baseline and Month 6

  39. Olmesartan: Time-adjusted Change From Baseline Through Month 6 in 24-hour Mean DBP, Assessed by ABPM - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for DBP assessed by ABPM were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  40. Olmesartan: Time-adjusted Change From Baseline Through Month 6 in Office DBP - All Collected Data

    Time-adjusted change was defined as the AUC of BP change from baseline divided by the duration of the time period. LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for office DBP were included in the analysis for this endpoint.

    Measured: Baseline through Month 6

  41. Olmesartan: Change From Baseline in Daytime and Nighttime SBP and DBP by ABPM at Each Visit - All Collected Data

    ABPM device was programmed to take readings every 20 minutes during the day (6 am to 9:59 pm) and every 30 minutes during the night (10 pm to 5:59 am). An ABPM was considered adequate if: 1. the number of successful daytime readings were ≥33; 2. the number of successful nighttime readings were ≥11; and 3. no more than 3 hours are not represented (i.e., 3 sections of 60 minutes where 0 valid readings were obtained). LS mean and SE were calculated using a MMRM approach. Treatment policy strategy was used for the intercurrent event of using antihypertensive escape medication, i.e., all collected data for daytime and nighttime SBP and DBP, assessed by ABPM, were included in the analysis for this endpoint.

    Measured: Baseline, and Month 2, 3 and 6

  42. Olmesartan: Percent Change From Baseline in Serum AGT

    Measured: Baseline, Week 2 and Months 1, 2, 3, 4, 5 and 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted2 Nov 2021
  2. Study start5 Nov 2021
  3. Primary completion11 Dec 2023
  4. Study completion13 Sep 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
663 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05103332
Sponsor's protocol ID
ALN-AGT01-003
Other IDs
2021-003776-13
Acronym
KARDIA-2
Status last verified
Oct 2025
First submitted
22 Oct 2021
Last updated
3 Nov 2025
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Access to Anonymized individual participant data that support these results is made available 12 months after study completion and not less than 12 months after the product and indication have been approved in the United States (US) and/or the European Union (EU). Data will be provided contingent upon the approval of a research proposal and the execution of a data sharing agreement. Requests for access to data can be submitted via the website www.vivli.org.

Publications

  • Desai AS, Karns AD, Badariene J, Aswad A, Neutel JM, Kazi F, Park W, Stiglitz D, Makarova N, Havasi A, Zappe DH, Saxena M; KARDIA-2 Study Group. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension: The KARDIA-2 Randomized Clinical Trial. JAMA. 2025 Jul 1;334(1):46-55. doi: 10.1001/jama.2025.6681.

    PubMed 40434761

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