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Zilebesiran is an investigational small interfering RNA (siRNA) therapeutic developed for the treatment of hypertension. It is administered subcutaneously and specifically targets hepatic synthesis of angiotensinogen, the most upstream precursor in the renin–angiotensin–aldosterone system (RAAS), a key pathway in blood pressure regulation. By reducing AGT mRNA levels in the liver, zilebesiran leads to decreased production of angiotensinogen, resulting in lower circulating levels of angiotensin II and sustained reductions in blood pressure. Zilebesiran utilizes GalNAc-conjugate technology for targeted delivery to hepatocytes, enabling durable RAAS inhibition with infrequent dosing—potentially as little as twice yearly or quarterly. Clinical trials have shown that single doses can significantly reduce systolic blood pressure for up to six months with a favorable safety profile[1][2][3][4][5][6].
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