Zilebesiran
Zilebesiran has been studied in 16 papers since 2023: 1 trial in people, 1 in animals, 14 reviews; 15 in the past year. Its furthest trials in people are at phase 3. The newest paper, Nov 9, 2026: “New Drugs in the Treatment of Uncontrolled or Resistant Hypertension”.
16 papers study it18 findingsUpdated
9 new papers in 30 daysSee all 15 papers on zilebesiran
At a glance
The findings reach people, from one lab or study. 4 independent labs in 2 countries; 7 trials, none about aging, 2 with no results posted.
“for zilebesiran 300 and 600 mg were –9.2 (–17.3, –1.2) and –7.0 (–15.3, 1.3) mmHg, respectively, for office”
None of its findings points the other way.
- 4 independent labs in 2 countries
- 7 trials, none about aging, 2 with no results posted
- 2 of 8 findings with company ties
- 7 of 7 trials sponsored by its developers
- Human trial1
- Animals1
Studies in people
1 study gave zilebesiran to people and measured what changed.
| What changed | Design | People | Source |
|---|---|---|---|
down: Decreases office systolic blood pressurePlacebo-adjusted change −9.2 mmHg (95% CI −17.3 to −1.2) no change: Has no effect on adverse event rate31 (43.7%) versus 17 (43.6%) with placebo | Randomized trial3 months | 110 peopleBothmean age: 66.0 yearsOlder adults; Uncontrolled hypertension, background diuretic use, and baseline office systolic blood pressure ≥140 mmHg | ESC Congress 2026 abstract, Oct 26, 2026 |
What did studies of zilebesiran find?
12Studies of zilebesiran measured 12 outcomes, among them blood pressure, systolic blood pressure and systolic blood pressure.
Blood pressure
downin humans2
2 studies
Blood pressure
downin humans2
Zilebesiran decreases blood pressure in humans (hypertension).
“zilebesiran producing prolonged suppression of angiotensinogen synthesis and sustained antihypertensive effects after infrequent subcutaneous administration.”
ReviewhypertensionsiRNA
New Drugs in the Treatment of Uncontrolled or Resistant Hypertension
Pharmaceuticals (Basel, Switzerland)
Zilebesiran decreases blood pressure in clinical trials.
“Recent translational advances, including RNA-based therapeutics such as small interfering RNAs (zilebesiran) and antisense oligonucleotides (tonlamarsen), demonstrate promising blood pressure reductions and favorable safety profiles in clinical trials.”
Reviewin clinical trials
Angiotensinogen Reconsidered: Evolving Perspectives in Hypertension Research
Hypertension (Dallas, Tex. : 1979)
Systolic blood pressure
downin humans2
2 studies
Systolic blood pressure
downin humans2
Zilebesiran decreases systolic blood pressure in humans (more than 15 mm Hg reduction).
“zilebesiran lowered systolic blood pressure by more than 15 mm Hg with sustained effects for up to 24 weeks.”
Reviewup to 24 weeks
Cardiology in review
Zilebesiran decreases systolic blood pressure in humans (hypertension) (Office: −7.6 mmHg (95% CrI −8.7 to −6.6); ambulatory: −6.9 mmHg (95% CrI −10.6 to −3.6)).
“Bayesian posterior mean reductions were −7.6 mmHg (95% CrI: −8.7 to −6.6) for office and −6.9 mmHg (95% CrI: −10.6 to −3.6) for ambulatory SBP”
Reviewhypertension10–800 mgn = 1,491
ESC Congress 2026 abstract
Systolic blood pressure
downin humans2
2 studies
Systolic blood pressure
downin humans2
Zilebesiran decreases systolic blood pressure in humans.
“zilebesiran demonstrated significant reductions in 24-h ambulatory SBP at Month 3 compared with placebo across all background therapies.”
ReviewMonth 3
ESC Congress 2026 abstract
Zilebesiran decreases systolic blood pressure in humans (hypertension) (- 10 to - 27 mmHg).
“clinically significant reductions in 24-h systolic BP (- 10 to - 27 mmHg)”
Reviewhypertensionsingle subcutaneous injectionup to 6 months
Zilebesiran: an RNA interference agent-its need and potential to transform hypertension treatment
The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology
Blood pressure
downin humans2
2 studies
Blood pressure
downin humans2
Zilebesiran decreases blood pressure in randomized controlled trials.
“Novel therapies including RNAi Zilebesiran and aldosterone synthase inhibitors (lorundrostat and baxdrostat) have demonstrated efficacy and safety in large, robust randomized controlled trials with good safety/tolerability and clinically significant BP reduction”
Reviewin randomized controlled trials
New pharmacological therapies for hypertension
Current opinion in nephrology and hypertension
Zilebesiran decreases blood pressure in humans.
“Zilebesiran, designed to reduce angiotensinogen secretion, significantly decreases systolic and diastolic blood pressure (BP).”
Review
International journal of molecular sciences
24-hour ambulatory systolic blood pressure
downin humans1
1 study
24-hour ambulatory systolic blood pressure
downin humans1
Zilebesiran decreases 24-hour ambulatory systolic blood pressure in humans (Hypertension; versus placebo or standard therapy) (-11.92 mm Hg (95% CI -15.68 to -8.17)).
“Zilebesiran significantly reduced 24-hour ambulatory systolic blood pressure versus placebo or standard therapy, with a pooled mean difference of -11.92 mm Hg”
ReviewHypertension; versus placebo or standard therapyApproximately 3 months
AHA Scientific Sessions 2026 abstract
Circulating angiotensinogen
downin humans1
1 study
Circulating angiotensinogen
downin humans1
Zilebesiran decreases circulating angiotensinogen in humans (hypertension).
“Zilebesiran has demonstrated sustained reductions in circulating angiotensinogen and ambulatory blood pressure following infrequent subcutaneous administration in phase 1 and phase 2 clinical trials.”
Reviewhypertension
Current cardiology reports
Ambulatory blood pressure
downin humans1
1 study
Ambulatory blood pressure
downin humans1
Zilebesiran decreases ambulatory blood pressure in humans (hypertension).
“Zilebesiran has demonstrated sustained reductions in circulating angiotensinogen and ambulatory blood pressure following infrequent subcutaneous administration in phase 1 and phase 2 clinical trials.”
Reviewhypertension
Current cardiology reports
Incremental blood pressure lowering
no changein humans1
1 study
Incremental blood pressure lowering
no changein humans1
Zilebesiran showed no clear effect on incremental blood pressure lowering in humans (dose escalation above 600 mg) (Efficacy saturation between 300 mg and 600 mg; negligible incremental lowering above 600 mg).
“Doses above 600 mg (up to 800 mg) provided negligible incremental BP lowering”
Reviewdose escalation above 600 mg>600–800 mg
ESC Congress 2026 abstract
Adverse event rate
no changein humans1
1 study
Adverse event rate
no changein humans1
Zilebesiran showed no clear effect on adverse event rate in humans (31 (43.7%) versus 17 (43.6%) with placebo).
“Adverse event (AE) rates were similar in zilebesiran and placebo groups (31 [43.7%] vs 17 [43.6%]).”
Human trialUncontrolled hypertension, background diuretic use, and baseline office systolic blood pressure ≥140 mmHg; compared with placebo300 or 600 mg6 monthsfemale: 48.2%sn = 110
ESC Congress 2026 abstract
Office systolic blood pressure
downin humans1
1 study
Office systolic blood pressure
downin humans1
Zilebesiran decreases office systolic blood pressure in humans (Placebo-adjusted change −9.2 mmHg (95% CI −17.3 to −1.2)).
“for zilebesiran 300 and 600 mg were –9.2 (–17.3, –1.2) and –7.0 (–15.3, 1.3) mmHg, respectively, for office”
Human trialUncontrolled hypertension, background diuretic use, and baseline office systolic blood pressure ≥140 mmHg; compared with placebo300 mg3 monthsfemale: 48.2%sn = 110
ESC Congress 2026 abstract
All 12Fewer
What is zilebesiran linked with?
2Studies link zilebesiran with 2 measures: renal function decline and hyperkalemia.
Renal function decline
upin humans1RR 2.8
1 study
Renal function decline
upin humans1RR 2.8
Zilebesiran raises the risk of renal function decline in humans (RR 2.80; 95% CI 1.38 to 5.67; p < 0.01).
“renal function decline (eGFR decrease ≥ 30%) (RR 2.80; 95% CI 1.38 to 5.67; p < 0.01).”
Review
ESC Congress 2026 abstract
Hyperkalemia
upin humans1RR 3.24
1 study
Hyperkalemia
upin humans1RR 3.24
Zilebesiran raises the risk of hyperkalemia in humans (RR 3.24; 95% CI 1.40 to 7.49; p < 0.01).
“zilebesiran was associated with a significantly higher risk of hyperkalaemia (RR 3.24; 95% CI 1.40 to 7.49; p < 0.01)”
Review
ESC Congress 2026 abstract
Has zilebesiran been tested in people?
0 of 7 about agingYes: 1 trial in people have been published, and 5 trials are registered.
In trials
Phase 3Recruiting5 trials
Phase 3Recruiting2 trials
Phase 2Completed1 trial
Who is developing zilebesiran?
1 company: Alnylam Pharmaceuticals.
- Companies
- Alnylam PharmaceuticalsPhase 3high risk cardiovascular disease, hypertension
Trial sponsors
Company5 trialsPhase 311,929 people