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The purpose of this study is to evaluate the blood pressure (BP)-lowering efficacy of tonlamarsen in adult participants who, despite taking 2 or more antihypertensive medications, have not achieved their target blood pressure (BP).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tonlamarsen | Experimental | 1 dose of placebo and 5 doses of active drug will be administered by subcutaneous (SC) injection |
|
| Placebo | Placebo Comparator | 5 doses of placebo and 1 dose of active drug will be administered by subcutaneous (SC) injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tonlamarsen | Drug | Tonlamarsen will be administered subcutaneously (SC) every 4 weeks during the randomized part of the study |
|
| Measure | Description | Time Frame |
|---|---|---|
| To assess the effect of tonlamarsen on plasma angiotensinogen (AGT) levels | Percent Change from baseline (Week 0) in plasma angiotensinogen (AGT) levels to Week 20 | Week 20 |
| To assess the systolic blood pressure-lowering efficacy of tonlamarsen | Change from baseline (Week 0) in mean office seated systolic blood pressure to Week 20 | Week 20 |
| Measure | Description | Time Frame |
|---|---|---|
| To assess the safety and tolerability of tonlamarsen | Incidence and severity of treatment emergent adverse events (TEAEs). Incidence of clinically significant abnormalities in laboratory assessments, ECGs and vital signs. Incidence of: (1) Hyperkalemia, defined as serum potassium >5.5 mmol/L. (2) Hypotension, defined as systolic blood pressure <90 mmHg, or systolic blood pressure <100 mmHg and symptomatic and/or requiring clinical intervention. (3) Renal dysfunction, defined as a decrease of eGFR >30% from baseline value. (4) Increased proteinuria, defined as UPCR >0.5 mg/mg from baseline value. |
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Key Inclusion Criteria:
Key Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pinnacle Research Group | Anniston | Alabama | 36207 | United States | ||
| Achieve Clinical Research, LLC |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41949512 | Derived | Laffin LJ, Wang Q, Sarraju A, Touyz RM, Schlaich MP, Cohen DL, Mahfoud F, Mitchell LM, Mitchell J, Wolski K, Dennis P, Akere A, Li W, Chen G, Cohen YZ, Kim J, Cooper CG, Ramesan P, Edelberg JM, Nissen SE; KARDINAL Investigators. Efficacy of Tonlamarsen in Patients With Uncontrolled Hypertension: The KARDINAL Phase 2 Randomized Clinical Trial. J Am Coll Cardiol. 2026 May 12;87(18):2508-2520. doi: 10.1016/j.jacc.2026.03.034. Epub 2026 Mar 28. |
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Once eligibility is confirmed during screening, there will be two run-in periods (Part A and Part B). Eligible participants will then be randomized to tonlamarsen or placebo (Part C).
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| Placebo | Drug | Placebo will be administered subcutaneously (SC) every 4 weeks during the randomized part of the study |
|
| Week 28 |
| To assess the efficacy of tonlamarsen in achieving office seated systolic blood pressure <130 mmHg | Proportion of participants with mean office seated systolic blood pressure <130 mmHg at Week 20 | Week 20 |
| To assess the systolic blood pressure-lowering efficacy of tonlamarsen | Change from baseline (Week 0) in mean self-assessed home systolic blood pressure through Week 20 | Week 20 |
| To assess the effect of tonlamarsen on severe systolic blood pressure elevations | Proportion of participants with any daily average home systolic blood pressure ≥150 mmHg at Week 20 | Week 20 |
| To assess the diastolic blood pressure-lowering efficacy of tonlamarsen | Change from baseline (Week 0) in mean office seated diastolic blood pressure to Week 20 | Week 20 |
| Birmingham |
| Alabama |
| 35216 |
| United States |
| Elite Clinical Studies | Phoenix | Arizona | 85018 | United States |
| Del Sol Research Management, LLC | Tucson | Arizona | 85715 | United States |
| Cardiology and Medicine Clinic | Little Rock | Arkansas | 72204 | United States |
| North Coast Cardiology | Encinitas | California | 92024 | United States |
| Orange County Research Center | Lake Forest | California | 92630 | United States |
| Clinical Trials Research | Lincoln | California | 95648 | United States |
| American Institute of Research | Los Angeles | California | 90017 | United States |
| Homestead Associates in Research, Inc. | Homestead | Florida | 33033 | United States |
| Jacksonville Center for Clinical Research | Jacksonville | Florida | 32216 | United States |
| Suncoast Clinical Research, Inc. | New Port Richey | Florida | 34652 | United States |
| Progressive Medical Research | Port Orange | Florida | 32127 | United States |
| Agile Clinical Research Trials, LLC | Atlanta | Georgia | 30328 | United States |
| Velocity Clinical Reseach | Savannah | Georgia | 31406 | United States |
| Eagle Clinical Research | Chicago | Illinois | 60621 | United States |
| Clinical Investigation Specialists, Inc. | Gurnee | Illinois | 60031 | United States |
| Koch Family Medicine Clinical Research | Morton | Illinois | 61550 | United States |
| Tandem Clinical Research GI, LLC | Marrero | Louisiana | 70072 | United States |
| IMA Clinical Research | Monroe | Louisiana | 71201 | United States |
| DelRicht Clinical Research - New Orleans | New Orleans | Louisiana | 70115 | United States |
| ActivMed Practices & Research, LLC | Methuen | Massachusetts | 01844 | United States |
| Oakland Medical Research Center | Troy | Michigan | 48085 | United States |
| Olive Branch Family Medical Center | Olive Branch | Mississippi | 38654 | United States |
| Richmond University Medical Center | Staten Island | New York | 10310 | United States |
| CHEAR Center LLC | The Bronx | New York | 10455 | United States |
| IMA Clinical Research | Lenoir | North Carolina | 28645 | United States |
| Clinical Trials of South Carolina | Moncks Corner | South Carolina | 29461 | United States |
| Health Concepts | Rapid City | South Dakota | 57702 | United States |
| Holston Medical Group | Kingsport | Tennessee | 37660 | United States |
| Central Texas Clinical Research | Austin | Texas | 78705 | United States |
| Advanced Medical Trials, LLC | Georgetown | Texas | 78628 | United States |
| Juno Research, LLC | Houston | Texas | 77040 | United States |
| Radiance Clinical Research | Lampasas | Texas | 76550 | United States |
| Synergy Groups Medical, LLC | Missouri City | Texas | 77459 | United States |
| North Hills Medical Research | North Richland Hills | Texas | 76180 | United States |
| Sun Research Institute | San Antonio | Texas | 78215 | United States |
| Manassas Clinical Research Center | Manassas | Virginia | 20110 | United States |
| York Clinical Research LLC | Norfolk | Virginia | 23504 | United States |
| ID | Term |
|---|---|
| D006973 | Hypertension |
| ID | Term |
|---|---|
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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