An Integrated Assessment of the Safety and Effectiveness of Bexagliflozin for the Management of Essential Hypertension

To be eligible for randomization a prospective subject was to be:

• Male or female of age ≥ 20 years

• Diagnosed with essential hypertension and exhibiting an office seated SBP ≥ 140 and < 180 mm Hg

• Unmedicated or prescribed no more than 4 agents for hypertension. Unmedicated subjects were subjects who had never taken medications for hypertension or had not taken any anti-hypertensive medication for at least 3 months. A stable dose meant no change in dose or frequency had taken place in the 4 weeks prior to the screening visit

• If female and of childbearing potential, willing to use an adequate method of contraception and to not become pregnant for the duration of the study.

• Willing and able to return for all clinic visits and to complete all study-required procedures

• Able to self-medicate during the run-in period, omitting no more than one day of dosing

• Shown to have a seated SBP ≥ 140 and < 180 mm Hg

• Shown to exhibit a mean 24 h SBP ≥ 135 mm Hg

Prospective participants exhibiting any of the following characteristics were to be excluded from the study:

• Diagnosis of type 1 diabetes mellitus or maturity-onset/diabetes of the young (MODY)

• Known history of secondary or malignant hypertension

• Seated diastolic blood pressure (DBP) >110 mm Hg at screening

• Taking insulin for diabetes

• Prescribed more than 4 anti-hypertension medications

• Having a genitourinary tract infection within 6 weeks of screening or history of ≥ 3 genitourinary infections requiring treatment within the last 6 months

• Having cancer, active or in remission for < 3 years

• History of alcohol or illicit drug abuse in the past 2 years

• History of myocardial infarction, stroke or hospitalization for heart failure in the prior 6 months

• Previous exposure to bexagliflozin or EGT0001474

• History of hypertensive emergency

• History of sodium glucose linked transporter 2 (SGLT2) inhibitor treatment in the last 3 months

• Known intolerance or allergy to SGTL2 inhibitors

• Any condition, disease, disorder, or clinically relevant laboratory abnormality that, in the opinion of the PI, would jeopardize the subject's appropriate participation in this study or obscure the effects of treatment

• Pregnancy or nursing

• Current participation in another interventional trial or having been exposed to an investigational drug within 30 days or 7 half-lives of screening, whichever is longer

• Arm circumference too large or small to allow accurate ambulatory monitoring

• History of kidney transplant

• Occupational or other lifestyle factors that could hamper the collection of valid ABPM data

• Evidence of abnormal liver function tests (total bilirubin or alkaline phosphatase > 1.5 × upper limit of normal (ULN) with the exception of isolated Gilbert's syndrome); or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 × ULN

• Estimated glomerular filtration rate (eGFR), as calculated by the modification of diet in renal disease study equation (MDRD), < 45 mL/min/1.73 m2 or requiring dialysis

• HbA1c > 9.5%

• Positive urine pregnancy test for female subjects of child bearing potential

• Evidence of abnormal liver function tests (total bilirubin or alkaline phosphatase > 1.5 × upper limit of normal (ULN) with the exception of isolated Gilbert's syndrome); or alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 × ULN

• eGFR, as calculated by the modification of diet in renal disease study equation (MDRD), < 45 mL/min/1.73 m2 or requiring dialysis

• HbA1c > 9.5%

• Positive urine pregnancy test for female subjects of child bearing potential