FDA Approves Baxfendy (baxfendy) for Hypertension in Adults Not Adequately Controlled
The FDA has approved Baxfendy (baxfendy), an aldosterone synthase inhibitor, for the treatment of hypertension in adults who are not adequately controlled on other antihypertensive agents. The drug is indicated for use in combination with other antihypertensives to lower blood pressure, which reduces the risk of cardiovascular events such as stroke and myocardial infarction. However, the label notes that no controlled trials have demonstrated risk reduction of these events specifically with Baxfendy. The approval was supported by a phase 3 trial (BaxHTN) that evaluated the efficacy of Baxfendy 1 mg and 2 mg once daily versus placebo in patients with systolic blood pressure ≥135 mmHg despite at least two antihypertensive medications. The primary endpoint was change from baseline to Week 12 in seated office systolic blood pressure. Clinicians should consider the risk of hyperkalemia and hyponatremia before initiating therapy.
+ Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Baxfendy is an aldosterone synthase inhibitor.
Baxfendy, in combination with other antihypertensive drugs, is indicated for the treatment of hypertension to lower blood pressure in adults who are not adequately controlled on other agents.
Consider the patient's risk of hyperkalemia and hyponatremia before initiating Baxfendy. Assess serum potassium and sodium before initiation and periodically thereafter. Correct abnormalities prior to initiation. The recommended dosage is 2 mg orally once daily. For patients at increased risk of hyperkalemia or hyponatremia, the recommended dosage is 1 mg once daily. Swallow tablets whole; do not cut, crush, or chew. May be taken with or without food. If a dose is missed, take the next dose at the usual time; do not double the dose.
Efficacy was evaluated in a phase 3, multicenter trial (BaxHTN, NCT06034743) in adults with systolic blood pressure ≥140 and <170 mmHg on at least 2 antihypertensives including one diuretic, with eGFR ≥45 mL/min/1.73 m2 and serum potassium 3.5 to <5.0 mEq/L. After a 2-week placebo run-in, 794 patients with systolic blood pressure ≥135 mmHg were randomized to Baxfendy 1 mg, Baxfendy 2 mg, or placebo once daily for 12 weeks. The primary endpoints were change from baseline to Week 12 in seated office systolic blood pressure for each dose versus placebo. A key secondary endpoint was change in seated office systolic blood pressure during an 8-week randomized withdrawal period (Week 24 to Week 32). Trial data not available in label for specific numerical results.
Consider the risk of hyperkalemia and hyponatremia before initiating Baxfendy. Assess serum potassium and sodium before initiation and periodically thereafter. Correct abnormalities prior to initiation. Not reported in label for other warnings or contraindications.
Baxfendy is an aldosterone synthase inhibitor indicated as add-on therapy for hypertension in adults not adequately controlled on other agents. It is not a first-line agent and should be used in combination with other antihypertensives. The label emphasizes that blood pressure reduction reduces cardiovascular risk, but no trials have demonstrated such risk reduction specifically with Baxfendy.