BI 1072668

BI 1072668 is a potent and selective small molecule inhibitor of aldosterone synthase (CYP11B2), currently under development by Boehringer Ingelheim. Aldosterone synthase is the enzyme responsible for the final steps of aldosterone biosynthesis in the adrenal cortex. Pathologically high levels of aldosterone are known to drive cardiorenal damage, promoting inflammation, fibrosis, and hypertension. BI 1072668 is primarily being investigated for the treatment of chronic kidney disease (CKD), where it aims to provide renal protection by directly lowering aldosterone production. A key pharmacological feature of BI 1072668 is its high selectivity for CYP11B2 over the closely related enzyme CYP11B1 (11β-hydroxylase), which is essential for cortisol synthesis; this selectivity is intended to minimize the risk of adrenal insufficiency. The drug is currently being evaluated in Phase 2 clinical trials to assess its efficacy in reducing albuminuria and slowing the progression of kidney disease.