Two Injections A Year For Blood Pressure? Lancet Review Highlights Breakthrough Therapy

New siRNA-based drug may reduce need for daily pills; experts say trials still underway

A major shift in the treatment of high blood pressure may be on the horizon, with new research suggesting that just two injections a year could help control hypertension.

A recent review published in The Lancet, titled The New Drug Therapies for Hypertension, has highlighted promising late-stage treatments currently under global trials. Among the most advanced candidates is Zilebesiran (also referred to as Jilebesiran in some reports), a drug that could potentially reduce dependence on daily blood pressure tablets.

How the new therapy works

Zilebesiran is based on small interfering RNA (siRNA) technology. Instead of simply lowering blood pressure numbers, the therapy targets the disease pathway itself. It suppresses the liver’s production of angiotensinogen, a protein that plays a central role in regulating blood pressure.

By blocking this pathway, a single subcutaneous injection has shown the ability to reduce systolic blood pressure for up to six months. This means patients may only need two injections per year to maintain control.

The drug, being developed by Roche and Alnylam Pharmaceuticals, is currently in Phase 3 clinical trials after encouraging mid-stage results. Some findings have also been reported in the New England Journal of Medicine.

Why this matters

Hypertension is often called a “silent killer” because it increases the risk of heart attacks, strokes and premature death without obvious symptoms. The World Health Organization defines high blood pressure as readings of 140/90 mm Hg or higher, while normal levels are below 120/80 mm Hg.

Globally, around 1.4 billion adults aged 30 to 79 live with hypertension. Nearly 44 per cent are unaware of their condition, and fewer than one in four diagnosed patients have adequate control.

In India, the 2023 ICMR-INDIAB study estimated that more than 315 million people are affected. National Family Health Survey-5 data also shows that many diagnosed patients do not maintain proper control.

Current treatment guidelines recommend combinations of oral drugs such as ACE inhibitors, angiotensin receptor blockers, calcium channel blockers and diuretics. While effective, long-term adherence remains a major challenge. Many patients manage multiple conditions like diabetes or high cholesterol, leading to “pill fatigue” and missed doses.

Long-acting injectable therapies aim to address this adherence gap by reducing the frequency of medication and improving consistency.

Experts caution that while results so far are promising, the therapy is still undergoing clinical evaluation. Wider availability will depend on the completion of Phase 3 trials, regulatory approvals and long-term safety data.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Patients should consult qualified healthcare professionals before making any changes to their treatment.