Method of reducing AGT expression for treating cardiovascular disease
Patent Information
- Application Number
- PCT/CN2026/079696
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2025-10-31
- Filing Date
- 2026-02-23
- Publication Date
- 2026-08-27
Smart Images

Figure PCTCN2026079696-FTAPPB-I100001 
Figure PCTCN2026079696-FTAPPB-I100002 
Figure PCTCN2026079696-FTAPPB-I100003
Abstract
Description
METHOD OF REDUCING AGT EXPRESSION FOR TREATING CARDIOVASCULAR DISEASEFIELD OF THE DISCLOSURE
[0001] The instant application relates to the use of double-stranded (ds) RNA agents to reduce Angiotensin (AGT) expression for the treatment of cardiovascular disease. Related Applications
[0002] This application claims priority to PCT applications PCT / CN2025 / 078761 filed on February 24, 2025, with the China National Intellectual Property Administration, PCT / CN2025 / 106479 filed on July 1, 2025, with the China National Intellectual Property Administration, and PCT / CN2025 / 131705 filed on October 31, 2025, with the China National Intellectual Property Administration, each entitled “METHODS OF TREATMENT BY INHIBITING EXPRESSION OF ANGIOTENSINOGEN (AGT) PROTEIN, ” the entire contents of each of which is incorporated herein by reference in their entirety. Sequence Listing
[0003] The instant application contains a Sequence Listing, which has been submitted electronically in ST26 . xml format and is hereby incorporated by reference in its entirety. Said . xml copy, created on February 11, 2026, is named PAT059990-PCT-WO_SL. xml and is 31, 620 bytes in size.BACKGROUND
[0004] The renin-angiotensin-aldosterone system (RAAS) plays a key role in blood pressure regulation, and is implicated in the development and progression of cardiovascular disease. The RAAS cascade begins with the secretion of renin into the circulation by the juxtaglomerular cells of the kidney. Renin secretion is stimulated by several factors, including Na+ loading in the distal tubules, beta-sympathetic stimulation, and reduced renal perfusion. Angiotensin (AGT) is primarily produced by the liver. Active renin in the plasma splits angiotensinogen (produced by the liver) into angiotensin I, which is subsequently converted to angiotensin II by circulating and locally expressed angiotensin-converting enzyme (ACE) . Most of the effects of angiotensin II on the RAAS are exerted through its binding to the angiotensin II type 1 receptor (AT1R) , resulting in arterial vasoconstriction, as well as tubular and glomerular effects such as enhanced regulation of Na+ reabsorption or glomerular filtration rate. Together with other stimuli (such as corticotropin, anti-diuretic hormone, catecholamines, endothelin, and serotonin) as well as magnesium and potassium ion levels, AT1R stimulation leads to aldosterone release, which subsequently promotes excretion of Na+ and K+ in the distal tubules.
[0005] Dysregulation of the RAAS can result in, for example, excessive angiotensin II production and / or AT1R stimulation, which in turn can cause hypertension, which can lead to, for example, increased oxidative stress, promotion of inflammation, hypertrophy, and fibrosis in the heart, kidneys, and arteries, and also to, for example, left ventricular fibrosis, arterial remodeling, and glomerulosclerosis.
[0006] There are currently no approved therapies directly targeting AGT expression in the liver for treating cardiovascular disease. There is thus a need for improved cardiovascular disease therapies, particularly atherosclerotic cardiovascular diseases (ASCVD) , that target AGT. QCZ484, a dsRNA agent that inhibits AGT expression, specifically targets the liver to inhibit AGT production. Disclosed herein are methods and uses for improved treatment of cardiovascular disease with dsRNA agents such as QCZ484. SUMMARY OF THE DISCLOSURE
[0007] The present disclosure provides a method for reducing serum angiotensin (AGT) levels in a subject in need thereof comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of a 50-800 mg, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 2 to the subject, and wherein the serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels.
[0008] The present disclosure provides a method for treating cardiovascular disease in a subject in need thereof comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of a 50-800 mg, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 2, wherein the serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels.
[0009] In some embodiments, the cardiovascular disease is an atherosclerotic cardiovascular disease (ASCVD) . In some embodiments, the ASCVD is one or more of coronary heart disease (CHD) , myocardial infarction, angina, coronary artery stenosis, a cerebrovascular disease, a transient ischemic attack, ischemic stroke, hemorrhagic stroke, heart failure, kidney failure, carotid artery stenosis, a peripheral artery disease, claudication, an aortic atherosclerotic disease, abdominal aortic aneurysm, and descending thoracic aneurysm. In some embodiments, the cardiovascular disease is a non-atherosclerotic cardiovascular disease. In some embodiments, the non-atherosclerotic cardiovascular disease is one or more of spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging and stress-induced cardiomyopathy (Takotsubo syndrome) , non-atherosclerotic peripheral artery disease, fibromuscular dysplasia (FMD) , spontaneous coronary artery dissection (SCAD) , a congenital coronary artery anomaly, coronary aneurysm, coronary arteritis, coronary artery dissection, coronary artery thrombosis without underlying atherosclerotic plaque (thrombosis in situ) , a coronary embola, a coronary fistula, a coronary ostia, a fixed luminal obstruction, aneurysm, aortic dissection, embolus, occlusive fibroelastois, supravalvular aortic stenosis with severe intimal thickening, syphilis, Takayasu disease, intimal fibrous proliferation, myocardial oxygen demand supply disproportion, a systemic metabolic disorder, Fabry disease, homocystinuria, Hunter and Hurler diseases, primary oxalosis, Sandhoff disease, and intramural coronary artery disease.
[0010] In some embodiments, the dsRNA is administered parenterally, preferably subcutaneously.
[0011] In some embodiments, wherein the antisense strand and / or the sense strand further comprise at least one modified nucleotide. In some embodiments, the at least one modified nucleotide comprises 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof. In some embodiments, each of the sense and antisense strands comprises 1, 2, 3, or 4 phosphorothioate linkages. In some embodiments, each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is
[0012] In some embodiments, the sense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 3 and comprises the modifications of SEQ ID NO: 3, and the antisense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 4 and comprises the modifications of SEQ ID NO: 4.
[0013] In some embodiments, administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, or 95%compared to a baseline serum AGT level. In some embodiments, the reduction in serum AGT level is achieved by 29 days after administration. In some embodiments, the reduction in serum AGT level is achieved by 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, or 29 days after administration. In some embodiments, the reduction in serum AGT level is first achieved between 14 and 29 days after administration, between 22 and 29 days after administration, between 25 and 29 days after administration, or between 27 and 29 days after administration. In some embodiments, the reduction in serum AGT level is maintained for at least 24 weeks (e.g., at least 24 weeks, at least 6 months, at least 36 weeks, at least 9 months, at least 48 weeks, at least 12 months, at least 60 weeks, at least 15 months) after administration. In some embodiments, the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by 29 days after administration, and the serum AGT level is reduced by at least 80%relative to baseline at 24 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by 29 days after administration, and the serum AGT level is reduced by at least 80%relative to baseline at 48 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by 7, 14, 21, 22, 28, 29, or 35 days after administration, and the serum AGT level is reduced by at least 80%relative to baseline at 20, 24, 28, 32, 36, 42, 48, or 52 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by from 25 to 35 days after administration, and the serum AGT level is reduced by at least 80%relative to baseline at from 24 to 48 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by from 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, or 35 days after administration, and the serum AGT level is reduced by at least 50%relative to baseline at 24, 28, 32, 36, 40, 44, or 48 weeks after administration. In some embodiments, serum AGT level is reduced by at least 90%relative to baseline by from 20 to 35 days (for example, from 22 to 29 days) after administration, and the serum AGT level is reduced by at least 50%relative to baseline at from 24 to 48 weeks after administration.
[0014] In some embodiments, the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) . In some embodiments, the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg. In some embodiments, the dsRNA agent is administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.
[0015] In some embodiments, administration of the dsRNA agent achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration. In some embodiments, the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 3.9-6.1 hours, about 3.5-6.1 hours, about 3, 7-6.2 hours, about 4-6 hours, about 3.7 to 6.1 hours, about 3.8-6.1 hours, or about 4.5-5.5 hours) .
[0016] In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4.
[0017] In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , and wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue independently selected from and GLS-15 is
[0018] In some embodiments, the dsRNA agent is administered in conjunction with one or more additional therapeutic agents. In some embodiments, the one or more additional therapeutic agents comprises a diuretic, an angiotensin converting enzyme (ACE) inhibitor, a vascular Tensin II receptor antagonist, a beta-blocker, a vasodilator, a calcium channel blocker, an aldosterone antagonist, an alpha2-agonist, a renin inhibitor, an alpha-blocker, a peripherally acting adrenergic agent, a selective D1 receptor partial agonist, a non-selective alpha-adrenergic antagonist, a steroidal antimineralocorticoid, a hypertension agent, a low-density lipoprotein (LDL) -targeting agent, an RNAi agent other than the dsRNA agent, or a combination thereof.
[0019] The present disclosure provides a method of treating hypertension in a subject in need thereof, comprising administering a dose of a double-stranded ribonucleic acid (dsRNA) agent to the subject. The present disclosure also provides a method of lowering blood pressure in a subject in need thereof, comprising administering a dose of a double-stranded ribonucleic acid (dsRNA) agent to the subject. In some embodiments, the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleotide sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleotide sequence of SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleotide sequence and modifications of SEQ ID NO: 3, and an antisense strand comprising the nucleotide sequence and modifications of SEQ ID NO: 4. In some embodiments, the administering is effective to lower blood pressure in the subject. In some embodiments, the administering is effective to reduce the risk of a fatal cardiovascular event. In some embodiments, the administering is effective to reduce the risk of a nonfatal cardiovascular event. In some embodiments, the fatal cardiovascular event is a stroke or a myocardial infarction. In some embodiments the nonfatal cardiovascular event is a stroke or a myocardial infarction.
[0020] The present disclosure provides a method of treating hypertension for at least 6 months in a subject in need thereof comprising administering a 50-800 mg dose of a double-stranded ribonucleic acid (dsRNA) agent comprising agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 2, wherein administration of the dsRNA is effective to reduce the subject’s systolic blood pressure (SBP) by at least 10 mmHg compared to the subject’s baseline SBP level, and wherein administration of the dsRNA is effective to reduce the subject’s diastolic blood pressure (DBP) by at least 5 mmHg compared to the subject’s baseline DBP level, thereby treating the hypertension.
[0021] In some embodiments, the dsRNA is administered parenterally, preferably subcutaneously.
[0022] In some embodiments, the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide. In some embodiments, the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’ -O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof. In some embodiments, each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages. In some embodiments, each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is
[0023] In some embodiments, the sense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 3 and comprises the modifications of SEQ ID NO: 3, and the antisense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 4 and comprises the modifications of SEQ ID NO: 4.
[0024] In some embodiments, the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) . In some embodiments, the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg. In some embodiments, the dsRNA agent is administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.
[0025] In some embodiments, the administration of the dsRNA agent achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration. In some embodiments, the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .
[0026] In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4.
[0027] In some embodiments, the dsRNA agent is administered in conjunction with one or more additional therapeutic agents. In some embodiments, the one or more therapeutic agents comprises a diuretic, an angiotensin converting enzyme (ACE) inhibitor, a vascular Tensin II receptor antagonist, a beta-blocker, a vasodilator, a calcium channel blocker, an aldosterone antagonist, an alpha2-agonist, a renin inhibitor, an alpha-blocker, a peripherally acting adrenergic agent, a selective D1 receptor partial agonist, a non-selective alpha-adrenergic antagonist, a steroidal antimineralocorticoid, a hypertension agent, a low-density lipoprotein (LDL) -targeting agent, an RNAi agent other than the dsRNA agent, hypertension or a combination thereof.
[0028] The present disclosure provides a method for treating a cardiovascular disease in a subject in need thereof comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising a nucleotide sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4, and wherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels, thereby treating the subject’s cardiovascular disease. In some embodiments, the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at least 48 weeks after administration of the dsRNA agent compared to baseline serum AGT level. In some embodiments, administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 90%by 29 days after administration, and the serum AGT level is less than 50%compared to a baseline serum AGT level at 48 weeks after administration.
[0029] The present disclosure provides a method of treating hypertension for at least 6 months in a subject in need thereof comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg, wherein the dsRNA agent comprises a nucleotide sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising a nucleotide sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4, wherein administration the dsRNA is effective to reduce the subject’s systolic blood pressure (SBP) at least 10 mmHg compared to the subject’s baseline SBP level, and wherein administration the dsRNA is effective to reduce the subject’s diastolic blood pressure (DBP) at least 5 mmHg compared to the subject’s baseline DBP level, thereby treating the subject’s hypertension.
[0030] In some embodiments, the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) . In some embodiments, the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg.
[0031] The present disclosure provides a composition comprising a dsRNA agent for use in reducing serum AGT levels, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2, wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, and wherein the serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to the baseline serum AGT levels. In some embodiments, the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at least 48 weeks after administration of the dsRNA agent compared to baseline serum AGT level. In some embodiments, administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 90%by 29 days after administration, and the serum AGT level is less than 50%compared to a baseline serum AGT level at 48 weeks after administration.
[0032] The present disclosure provides a composition comprising a dsRNA agent for use in reducing systolic blood pressure, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2, wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, and wherein the blood pressure is reduced by at least 10 mmHg at least 3 months after administration of the dsRNA agent compared to the baseline systolic blood pressure levels.
[0033] The present disclosure provides a composition comprising a dsRNA agent for use in reducing diastolic blood pressure, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2, wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, and wherein the blood pressure is reduced by at least 10 mmHg at least 3 months after administration of the dsRNA agent compared to the baseline diastolic blood pressure levels.
[0034] In some embodiments, the composition is formulated for subcutaneous administration.
[0035] In some embodiments, the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide. In some embodiments, the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’ -O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof. In some embodiments, each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages. In some embodiments, each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is
[0036] In some embodiments, the composition comprises a 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) dose of the dsRNA agent. In some embodiments, the composition comprises a 150-300 mg (e.g., 150 mg) dose of the dsRNA agent. In some embodiments, the composition administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.
[0037] In some embodiments, administration of the composition achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration. In some embodiments, the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .
[0038] In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4.
[0039] The present disclosure provides a composition comprising a dsRNA agent for use in treating a cardiovascular disease, wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2, wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, and wherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels. In some embodiments, the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration. In some embodiments, the serum AGT level is reduced by at least 80%at least 48 weeks after administration of the dsRNA agent compared to baseline serum AGT level. In some embodiments, administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 90%by 29 days after administration, and the serum AGT level is less than 50%compared to a baseline serum AGT level at 48 weeks after administration.
[0040] In some embodiments, the cardiovascular disease is an atherosclerotic cardiovascular disease (ASCVD) . In some embodiments, the ASCVD is one or more of coronary heart disease (CHD) , myocardial infarction, angina, coronary artery stenosis, a cerebrovascular disease, a transient ischemic attack, ischemic stroke, hemorrhagic stroke, heart failure, kidney failure, carotid artery stenosis, a peripheral artery disease, claudication, an aortic atherosclerotic disease, abdominal aortic aneurysm, and descending thoracic aneurysm. In some embodiments, the cardiovascular disease is a non-atherosclerotic cardiovascular disease. In some embodiments, the non-atherosclerotic cardiovascular disease is one or more of spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging and stress-induced cardiomyopathy (Takotsubo syndrome) , non-atherosclerotic peripheral artery disease, fibromuscular dysplasia (FMD) , spontaneous coronary artery dissection (SCAD) , a congenital coronary artery anomaly, coronary aneurysm, coronary arteritis, coronary artery dissection, coronary artery thrombosis without underlying atherosclerotic plaque (thrombosis in situ) , a coronary embola, a coronary fistula, a coronary ostia, a fixed luminal obstruction, aneurysm, aortic dissection, embolus, occlusive fibroelastois, supravalvular aortic stenosis with severe intimal thickening, syphilis, Takayasu disease, intimal fibrous proliferation, myocardial oxygen demand supply disproportion, a systemic metabolic disorder, Fabry disease, homocystinuria, Hunter and Hurler diseases, primary oxalosis, Sandhoff disease, and intramural coronary artery disease.
[0041] In some embodiments, the composition is formulated for subcutaneous administration.
[0042] In some embodiments, the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide. In some embodiments, the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’ -O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof. In some embodiments, each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages. In some embodiments, each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is
[0043] In some embodiments, the composition comprises a 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) dose of the dsRNA agent. In some embodiments, the composition comprises a 150-300 mg (e.g., 150 mg) dose of the dsRNA agent. In some embodiments, the composition administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.
[0044] In some embodiments, administration of the composition achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration. In some embodiments, the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .
[0045] In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 3 and comprising the modifications of SEQ ID NO: 3, and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 4 and comprising the modifications of SEQ ID NO: 4.BRIEF DESCRIPTION OF THE DRAWINGS
[0046] FIG. 1 is a schematic illustration of a randomized, double-blind, placebo-controlled single ascending dose clinical trial to evaluate to assess the safety and tolerability of subcutaneous doses of QCZ484 in healthy subjects and subjects with mild hypertension.
[0047] FIG. 2 shows the plasma concentration of QCZ484 over time after a single subcutaneous dose in healthy patients.
[0048] FIG. 3 shows the change over time in serum AGT levels compared to baseline after a single subcutaneous dose of QCZ484 in healthy patients.
[0049] FIG. 4A shows the systolic blood pressure changes over time from baseline after a single subcutaneous dose of QCZ484 in healthy patients. FIG. 4B shows diastolic blood pressure changes over time from baseline after a single subcutaneous dose of QCZ484 in healthy patients.
[0050] FIG. 5 shows the plasma concentration over time of QCZ484 after a single subcutaneous dose in patients with mild hypertension.
[0051] FIG. 6 shows the percent change over time in serum AGT levels compared to baseline after a single subcutaneous dose of QCZ484 for patients with mild hypertension.
[0052] FIG. 7A shows the systolic blood pressure changes over time from baseline as measured in the doctor’s office after a single subcutaneous dose of QCZ484 in patients with mild hypertension. FIG. 7B shows diastolic blood pressure changes over time from baseline as measured in the doctor’s office after a single subcutaneous dose of QCZ484 in patients with mild hypertension.
[0053] FIG. 8A shows the 24 hour ambulatory systolic blood pressure changes over time from baseline after a single subcutaneous dose of QCZ484 in patients with mild hypertension. FIG. 8B shows 24 hour ambulatory diastolic blood pressure changes over time from baseline after a single subcutaneous dose of QCZ484 in patients with mild hypertension.
[0054] FIG. 9 is a schematic illustration of a randomized, double-blind, placebo-controlled Phase 2 clinical trial to evaluate the efficacy, safety, and pharmacodynamics of QCZ484 in subjects with mild to moderate hypertension.
[0055] FIG. 10 is a schematic illustration of Phase 2 Extension study to study to evaluate the long-term safety and efficacy of QCZ484 in hypertensive patients.
[0056] FIG. 11 shows the change over time in serum AGT levels compared to baseline after a single subcutaneous dose of QCZ484 in healthy patients.
[0057] FIG. 12 shows the change over time in serum AGT levels compared to baseline after a single subcutaneous dose of QCZ484 in patients with mild hypertension.
[0058] FIG. 13A shows the systolic blood pressure changes over time from baseline as measured by 24 hour ambulatory blood pressure monitor after a single subcutaneous dose of QCZ484 in subjects with mild hypertension. FIG. 13B shows the diastolic blood pressure changes over time from baseline as measured by 24 hour ambulatory blood pressure monitor after a single subcutaneous dose of QCZ484 in subjects with mild hypertension.DETAILED DESCRIPTIONA. Definitions
[0059] Baseline: as used herein, “baseline” refers to a measurement at any time point prior to administration of a dsRNA agent disclosed herein. A baseline measurement may be taken at a predetermined time before administration of a dsRNA agent disclosed herein, e.g., the baseline measurement is taken one day before administration. In some embodiments, a baseline measurement may be taken, e.g., 24 hours, 20 hours, 18 hours, 12 hours, 10 hours, 6 hours, 5 hours, 4 hours, 3 hours, 2 hours, 1 hour, 30 minutes, 15 minutes, 10 minutes, 5 minutes, or less, before administration of a dsRNA agent disclosed herein.
[0060] Blunt end: as used herein, “blunt end” refers to a configuration of terminal nucleotides (e.g., 3’ -end nucleotides, 5’ -end nucleotides, or 3’ -and 5’ -end nucleotides) of a dsRNA agent, wherein the terminal nucleotides of at least one end of the dsRNA agent form a complementary base-pair and there is no terminal nucleotide overhang on a strand that is not paired with a nucleotide on the other strand. A dsRNA agent may have blunt ends on the 3’ end, the 5’ end, or both the 3’ end and the 5’ end of the dsRNA agent.
[0061] Complementarity: as used herein, “complementarity” refers to base pairing of nucleotides, e.g., as determined by sequencing or by the ability of an oligonucleotide or polynucleotide comprising a first nucleotide sequence to hybridize (e.g., form hydrogen bonds between base pairs under mammalian physiological conditions or similar conditions in vitro) with an oligonucleotide comprising a second nucleotide sequence, and form a double helix or duplex structure under certain conditions. Other conditions may also apply, such as physiologically relevant conditions that may be encountered in living organisms. One skilled in the art will be able to determine the set of conditions most suitable for sequencing and / or testing the complementarity of two sequences based on the ultimate application of the hybridized nucleotides. Complementary sequences include Watson-Crick base pairs or non-Watson-Crick base pairs, and include natural or modified nucleotides or nucleotide mimics, at least to the extent that the above hybridization requirements are fulfilled. Sequence identity or complementarity is independent of modification. The term “partially complementary sequence” refers to a pair of nucleobase sequences in which at least 75% (but not all) of the bases in a contiguous sequence of a first polynucleotide form base pairs, e.g., as determined by hybridizing with the same number of bases in a contiguous sequence of a second polynucleotide. “Partially complementary” encompasses a hybridized pair of nucleotide sequences in which at least 76%, 77%, 78%, 79%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99%of the bases in a contiguous sequence of a first polynucleotide will hybridize with the same number of bases in a contiguous sequence of a second polynucleotide.
[0062] dsRNA agent: as used herein, “dsRNA agent” refers to a composition comprising an RNA or RNA-like (e.g. chemically modified RNA) oligonucleotide molecule that is capable of degrading or inhibiting translation of a target mRNA transcript. While not wishing to be bound to a particular theory, the dsRNA agents of the present disclosure may act through an RNA interference mechanism (for example, induce RNA interference by interacting with the RNA interference pathway machinery (RNA-induced silencing complex or RISC) of mammalian cells) , or act through any alternative mechanism (s) or pathway (s) . Methods for silencing genes in plant, invertebrate and vertebrate cells are known in the art (see for example Sharp et al., Genes Dev. 2001, 15: 485; Bernstein, et al., (2001) Nature 409: 363; Nykanen, et al., (2001) Cell 107: 309; and Elbashir, et al., (2001) Genes Dev. 15: 188) ) , the disclosures of which are incorporated herein by reference in their entirety. Gene silencing means known in the art can be used in conjunction with the disclosure provided herein to accomplish inhibition of AGT expression. An exemplary dsRNA agent is QCZ484.
[0063] Nucleotide: as used herein, “nucleotide” encompasses naturally occurring nucleotides (adenine (A) , guanine (G) , thymine (T) , cytosine (C) , and uracil (U) ) , as well as nucleotide mimics, modified nucleotides, nucleotide replacements, and abasic moieties.
[0064] Modified Nucleotide: as used herein, “modified nucleotide” refers to adenine (A) , guanine (G) , thymine (T) , cytosine (C) , uracil (U) nucleobases, or other nucleotides that are chemically altered by natural or synthetic means. A modified nucleotide encompasses a 2’ -O-methyl nucleotide, a 2’ -fluoro nucleotide, a 2'-deoxy nucleotide, a 2', 3'-seco nucleotide mimic, a locked nucleotide, an unlocked nucleic acid (UNA) nucleotide, a glycol nucleic acid (GNA) nucleotide, a 2'-F-arabinonucleotide, a 2'-methoxyethyl nucleotide, an abasic nucleotide, a ribitol, an inverted nucleotide, an inverted abasic nucleotide, an inverted 2'-OMe nucleotide, an inverted 2'-deoxy nucleotide, a 2'-amino modified nucleotide, a 2'-alkyl modified nucleotide, a morpholino nucleotide, a 3'-OMe nucleotide, a nucleotide including a 5'-phosphorothioate group, a terminal nucleotide linked to a cholesterol derivative or dodecanoic acid bisdecylamide group, a 2'-amino modified nucleotide, an isomannide, and a phosphoramidate.
[0065] In some embodiments described herein, one or more nucleotide strands of a dsRNA agent (e.g., a sense strand or an antisense strand) comprises one or more modified nucleotides and one or more non-nucleotide elements. In some embodiments, the components of the one or more strands is annotated such that each “a” is 2'-O-methyladenosine, each “c” is 2′-O-methylcytosine, each “g” is 2′-O-methylguanosine, each “u” is 2'-O-methyluridine, each “A” is 2'-fluoroadenosine, each “C” is 2'-fluorocytidine, each “G” is 2'-fluoroguanosine, each “U” is 2'-fluorouridine, each “*” is a phosphorothioate linkage, and each “Invab” is an inverted abasic residue independently selected from the group consisting of : In some embodiments, each GalNAc component of the one or more strands is annotated such that “GLS-15” is: It will be understood that a phosphorothioate linkage is a thiophosphate linkage.
[0066] Overhang: as used herein, “overhang” refers to at least one unpaired nucleotide at the end of a strand of a dsRNA agent. A dsRNA agent can contain an overhang comprising 1, 2, 3, 4, 5, 6, or more nucleotides. Overhangs may occur on the sense strand, the antisense strand, or on both strands of a dsRNA agent. Overhangs may occur on the 5’ end, the 3’ end, or both the 5’ and 3’ ends and on the sense, the antisense, or the sense and antisense strand of a dsRNA agent.
[0067] RNAi: as used herein, “RNAi” refers to an agent that comprises RNA and mediates targeted cleavage of an RNA transcript through an RNA-induced silencing complex (RISC) pathway. The term “RNAi” may be referred to as “siRNA” in the art.
[0068] Treatment: as used herein, the terms “treatment” , “therapeutic” or “treated” when used in reference to an AGT-associated disease or condition encompass a prophylactic treatment that prevents or decreases the likelihood of a subject developing the AGT-associated disease or condition. The term also refers to uses after the subject has developed or while the subject is developing an AGT-associated disease or condition in order to ameliorate, lessen, reduce, or eliminate one or more symptoms associated with the disease or condition, slowing or preventing the AGT-associated disease or condition from becoming more severe, and / or slowing the progression of the AGT-associated disease or condition in a subject as compared to the subject in the absence of the therapy to reduce AGT polypeptide activity and / or AGT polypeptide level in the subject.
[0069] About: as used herein, the terms “about” or “approximately” when used herein in the context of numerical values and ranges refers to values or ranges that approximate or are close to the recited values or ranges such that the embodiment may perform as intended, as is apparent to the skilled person from the teachings contained herein. Unless context indicates otherwise, “about” means plus or minus 10%of a numerical amount.
[0070] Standalone therapy: as used herein, the term “standalone therapy” refers to the use of a single active ingredient to treat a single disease or condition. It may refer to the use of a single agent, such as an dsRNA agent, used to treat an AGT-associated disease or condition. It may also refer to a situation where a subject is receiving one or more other active ingredients to treat other diseases or conditions, e.g., a subject is receiving a dsRNA agent to treat an AGT-associated disease or condition, and also receiving another active ingredient to treat a non-AGT-associated disease or condition.
[0071] Time-adjusted mean: as used herein, the term “time-adjusted mean” refers to a statistical calculation of a series of measurements, wherein the individual measurements in the series are adjusted depending on the time of day in which they were observed. It may refer to a time-adjusted mean of a subject’s blood pressure, wherein the individual blood pressure measurements are adjusted depending on the time of day in which they were taken from the subject. This statistical adjustment can be used to control for the daily fluctuation of blood pressure in a subject.
[0072] It will be understood that references to a “serum AGT level” is equivalent to references to “serum AGT levels” . B. Agents for Reducing AGT Expression
[0073] In various embodiments, the instant application provides double-stranded (ds) RNA agents capable of inhibiting expression of the angiotensinogen (AGT) gene. The disclosed dsRNA agents can be used to treat AGT-associated diseases and conditions. In some embodiments, the AGT-associated diseases or conditions comprises a cardiovascular disease, such as ASCVD. Without being bound by theory, the inventors considered AGT to be a therapeutic target for treating cardiovascular disease because AGT serves as a signaling molecule at the top of the RAAS signaling pathway, which plays a role in various cardiovascular diseases.
[0074] A sequence of human angiotensinogen (AGT) mRNA [NCBI reference sequence: NM_001384479.1] is provided below as SEQ ID NO: 5:
[0075] The dsRNA agents used in the methods disclosed herein may comprise a sense strand and an antisense strand, and include, but are not limited to short interfering RNA (siRNA) , RNAi agents, microRNA (miRNA) , short hairpin RNA (shRNA) and dicer substrates that target AGT mRNA transcripts. The antisense strand of a dsRNA agent may be at least partially complementary to the targeted mRNA, and dsRNA duplex structures of various lengths can be used to inhibit target gene expression. In some embodiments, the AGT dsRNA agents are capable of mediating cleavage of AGT mRNA transcripts through the RNA-induced silencing complex (RISC) pathway. In some embodiments, targeted cleavage of AGT mRNA transcripts mediated by an AGT dsRNA agent is capable of reducing AGT protein levels. In some embodiments, the dsRNA agent has blunt ends. In some embodiments, the dsRNA agent has overhangs. In preferred embodiments, the dsRNA agent has overhangs.
[0076] In some embodiments, the dsRNA agent binds to the AGT mRNA transcript at about position 1818 to position 1837. In preferred embodiments, the dsRNA agent comprises a sense strand nucleotide sequence of SEQ ID NO: 1 and an antisense strand nucleotide sequence of SEQ ID NO: 2 from QCZ484. In more preferred embodiments, the dsRNA agent comprises a sense strand nucleotide sequence of SEQ ID NO: 3 and an antisense strand nucleotide sequence of SEQ ID NO: 4 from QCZ484, as well as all the nucleotide modifications in those sequences. In even more preferred embodiments, the dsRNA agent comprises QCZ484.
[0077] In some embodiments, the dsRNA agent comprises a sense strand comprising a sequence having at least 90%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 90%identity to SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising a sequence having at least 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 90%identity to SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising a sequence having at least 95%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 95%identity to SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising a sequence having at least 99%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 99%identity to SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand comprising SEQ ID NO: 1 and an antisense strand comprising SEQ ID NO: 2. In some embodiments, the dsRNA agent comprises a sense strand consisting of SEQ ID NO: 1 and an antisense strand consisting of SEQ ID NO: 2. For any sequence referenced herein, it will be understood that the specific nucleotides of the sequence may be modified or unmodified. Table 1: Exemplary sense and antisense nucleotide sequences
[0078] Methods of preparing dsRNA agents are known in the art, such as those described in PCT / CN2022 / 131861 (including methods for preparing a dsRNA agent comprising SEQ ID NO: 1 and NO: 2) , which is hereby incorporated by reference in its entirety.
[0079] In some embodiments, the RNA of the AGT dsRNA agent is chemically modified to obtain enhanced stability and / or one or more other beneficial properties. In some embodiments, a dsRNA agent disclosed herein may comprise the unmodified nucleotide sequence of a specified SEQ ID NO disclosed herein. In some embodiments, a dsRNA agent disclosed herein may comprise the nucleotide sequence of a specified SEQ ID NO disclosed herein and at least one chemical modification (e.g., of a nucleotide backbone, base, or sugar, or of an internucleotide linkage, or at one or more of the dsRNA termini) . In some embodiments, a dsRNA agent disclosed herein may comprise the nucleotide sequence of a specified SEQ ID NO disclosed herein with every nucleotide having at least one chemical modification.
[0080] In some embodiments, a dsRNA agent disclosed herein may comprise one or more, e.g., all of, the modifications depicted in a chemically modified nucleotide sequence indicated by a specified SEQ ID NO disclosed herein. In certain embodiments, nucleic acids can be synthesized and / or modified by methods known in the art, see, for example, “Current protocols in Nucleic Acid Chemistry” , Beaucage, SL et al. (Eds. ) , John Wiley &Sons, Inc., New York, NY, USA and PCT / CN2022 / 131861, which are both incorporated herein by reference in their entireties. Modifications that may be present in certain embodiments of the AGT dsRNA agents include, for example: (a) terminal modifications, such as 5'end modifications (phosphorylation, conjugation, inverted linkages, etc. ) , 3'end modifications (conjugation, DNA nucleotides, inverted linkages, etc. ) ; (b) base modifications, e.g. replacement with stabilizing bases, destabilizing bases or bases pairing with an expanded partner pool, missing bases (abasic nucleotides) or conjugated bases; (c) sugar modifications (e.g., at the 2'position or 4'position) or substitution of sugars; and (d) backbone modifications, including modification or replacement of the phosphodiester bonds. Specific examples of RNA compounds that may be used in AGT dsRNA agents disclosed herein include, but are not limited to, RNAs comprising modified backbones or lacking natural internucleoside linkages.
[0081] As non-limiting examples, an RNA molecule may also comprise at least one modified nucleotide, including, but not limited to, a 2'-O-methyl nucleotide, a 2'-fluoro nucleotide, a 2'-deoxy nucleotide, a 2', 3'-seco nucleotide mimic, a locked nucleotide, an unlocked nucleic acid (UNA) nucleotide, a glycol nucleic acid (GNA) nucleotide, a 2'-F-arabinonucleotide, a 2'-methoxyethyl nucleotide, an abasic nucleotide, a ribitol, an inverted nucleotide, an inverted abasic nucleotide, an inverted 2'-OMe nucleotide, an inverted 2'-deoxy nucleotide, a 2'-amino modified nucleotide, a 2'-alkyl modified nucleotide, a morpholino nucleotide, a 3'-OMe nucleotide, a nucleotide including a 5'-phosphorothioate group, a terminal nucleotide linked to a cholesterol derivative or dodecanoic acid bisdecylamide group, a 2'-amino modified nucleotide, or a phosphoramidate, and combinations thereof. The structure of a 2’ -O-methyl nucleotide is shown below:
[0082]
[0083] The structure of a 2’ -fluoro nucleotide is shown below:
[0084]
[0085] Exemplary structures for inverted abasic residues are shown below: Inverted abasic residues may comprise a phosphorothioate group or linkage, which is represented in the following exemplary structures: In some embodiments, each inverted abasic residue is independently selected from the group consisting of: In some embodiments, a dsRNA agent described herein comprises a sense strand comprising at its 3’ end an invab with the following structure: In some embodiments, a dsRNA agent described herein comprises a sense strand comprising an invab having the structure wherein the invab is linked to a targeting group.
[0086] In some embodiments, an RNA molecule comprises the following number of modified ribonucleosides: at least 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21 or up to the full length of the nucleotide strand of the AGT dsRNA agent (as selected individually for each of the two strands in the dsRNA agent) . In some embodiments, the antisense strand sequence and / or the sense strand sequence of the dsRNA agent further comprise at least one nucleotide modification. In some embodiments, the at least one nucleotide modification comprises a 2’ -fluoro modified nucleoside, a 2’ -O-methyl modified nucleoside, or a combination thereof. In some embodiments, all the nucleotides in the antisense strand sequence and / or the sense strand sequence of the dsRNA agent are modified.
[0087] Modified RNA backbones may include, for example, phosphorothioates, chiral phosphorothioates, phosphorodithioates, phosphotriesters, aminoalkylphosphotriesters, methyl and other alkyl phosphonates (including 3'-alkylene phosphonates and chiral phosphonates) , phosphinates, phosphoramidates (including 3'-aminophosphoramidate and aminoalkyl phosphoramidates) , thiophosphoramidates, thioalkylphosphonates, thioalkylphosphotriesters, and boranophosphates (having normal 3'-5'linkages, as well as 2'-5'linkage analogues of these, and those with inverted polarity, in which adjacent pairs of nucleoside units are linked in a 3'-5'to 5'-3'or 2'-5'to 5'-2'format) . Methods for preparing phosphorus-containing bonds are known in the art, and such methods can be used to prepare modified AGT dsRNA agents. In some embodiments, the dsRNA agent comprises at least 1 phosphorothioate linkage. In some embodiments, the sense strand comprises 1, 2, 3, 4, 5, or 6 phosphorothioate linkages. In some embodiments, the antisense strand comprises 1, 2, 3, 4, 5, or 6 phosphorothioate linkages. In some embodiments, each of the sense strand and the antisense strand comprises 1, 2, 3, 4, 5, or 6 phosphorothioate linkages. In some embodiments, the sense strand comprises 2 phosphorothioate linkages. In some embodiments, the sense strand comprises 3 phosphorothioate linkages. In some embodiments, the sense strand comprises 4 phosphorothioate linkages. In some embodiments, the antisense strand comprises 3 phosphorothioate linkages. In some embodiments, the antisense strand comprises 4 phosphorothioate linkages.
[0088] The structure of a phosphorothioate linkage is shown below:
[0089]
[0090] Modified RNA backbones that do not contain a phosphorus atom therein may be used in the dsRNA agents of the disclosure. In some embodiments, these have structures formed of short-chain alkyl or cycloalkyl internucleoside linkages, mixed heteroatoms and alkyl or cycloalkyl internucleoside linkages, or one or more short chains heteroatomic or heterocyclic internucleoside linkages. They include those with morpholino bonds (formed in part from the sugar portion of a nucleoside) ; siloxane backbones; sulfide, sulfoxide and sulfone backbones; methylacetyl and thiomethylacetyl backbones; methylene methacetyl and thiomethylacetyl backbones; alkene containing backbones; sulfamate backbones; methyleneimino and methylenehydrazino backbones; sulfonate and sulfonamide backbones; amide backbones; and other parts with mixed N, O, S and CH2 components. Methods of preparing modified RNA backbones that do not contain phosphorus atoms are known in the art, and such methods can be used to prepare modified AGT dsRNA agents of the disclosure.
[0091] In certain embodiments, the AGT dsRNA compounds of the disclosure include at least one modified nucleotide, wherein the at least one modified nucleotide comprises: a 2'-O-methyl nucleotide, a 2'-fluoro nucleotide, a 2'-deoxy nucleotide, a 2', 3'-seco nucleotide mimic, a locked nucleotide, a 2'-F-arabino nucleotide, a 2'-methoxyethyl nucleotide, a 2'-amino modified nucleotide, a 2'-alkyl modified nucleotide, a morpholino nucleotide, a 3'-Ome nucleotide, a nucleotide containing a 5'-phosphorothioate group, a terminal nucleotide linked to a cholesterol derivative or dodecanoic acid bisdecylamide group, a 2'-amino modified nucleotide, a phosphoramidate, an unnatural base-containing nucleotide, or any combination thereof. In some embodiments, an AGT dsRNA compound contains an E-vinylphosphonate nucleotide at the 5'end of the antisense strand.
[0092] In certain embodiments, at least one modified nucleotide is included at a 3'a nd / or 5'end of a dsRNA agent, e.g., in the sense strand. In some embodiments, the at least one modified nucleotide comprises an abasic nucleotide, ribitol, inverted nucleotide, inverted abasic nucleotide, inverted 2'-OMe nucleotide, and / or inverted 2'-deoxynucleotide. The inclusion of abasic or inverted abasic nucleotides at the end of an oligonucleotide may enhance stability (Czauderna et al. Structural variations and stabilizing modifications of synthetic siRNAs in mammalian cells. Nucleic Acids Res. 2003; 31 (11) : 2705-2716. doi: 10.1093 / nar / gkg393) . In some embodiments, the 5’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, the 3’ -end of the antisense strand is conjugated to an inverted abasic residue. In some embodiments, each of the 5’ -end and 3’ -end of the sense strand is conjugated to an inverted abasic residue. In some embodiments, the 5’ -end and / or the 3’ -end of the sense strand is conjugated to an inverted abasic residue via a phosphorothioate linkage.
[0093] In some embodiments, an AGT dsRNA agent may comprise one or more chemically linked ligands, moieties or conjugates, for example, one or more chemically linked ligands, moieties or conjugates that enhance one or more characteristics of the AGT dsRNA agent. Non-limiting exemplary characteristics of the AGT dsRNA agent that can be enhanced are: AGT inhibitory activity; cellular distribution; delivery of the AGT dsRNA agent to a target tissue or cell type; pharmacokinetic properties of the AGT dsRNA agent; AGT dsRNA resistance to degradation, and cellular uptake of the AGT dsRNA agent. In some embodiments, the one or more chemically linked ligands, moieties, or conjugates enhance delivery of the dsRNA agent to liver cells. In some embodiments, the one or more chemically linked ligands, moieties, or conjugates enhance delivery of the dsRNA agent to the kidney cells. In some embodiments, the dsRNA agent disclosed herein has a half-life (T1 / 2) of at least 3.5 hours. In some embodiments, the dsRNA has a T1 / 2 of at least 4 hours. In some embodiments, the dsRNA agent has a T1 / 2 between 3.5 and 6.5 hours, between 3.5 and 6 hours, between 3.5 and 5 hours, between 4 and 6 hours, between 4 and 5 hours, between 4 and 5.5 hours, between 4 and 6.5 hours, between 4.5 and 5 hours, between 4.5 and 5.5 hours, between 4.5 and 6 hours, between 4.5 and 6.5 hours, between 5 and 5.5 hours, between 5 and 6 hours, between 5.5 and 6.5 hours, or between 6 and 6.5 hours. In some embodiments, the dsRNA agent has a T1 / 2 within a range of 3.5 to 6.5 hours, 3.5 to 6 hours, 3.5 to 5 hours, 4 to 6 hours, 4 to 5 hours, 4 to 5.5 hours, 4 to 6.5 hours, 4.5 to 5 hours, 4.5 to 5.5 hours, 4.5 to 6 hours, 4.5 to 6.5 hours, 5 to 5.5 hours, 5 to 6 hours, 5.5 to 6.5 hours, or 6 to 6.5 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 4 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 4.5 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 5 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 5.5 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 6 hours. In some embodiments, the dsRNA agent has a T1 / 2 of 6.5 hours. In some embodiments, the dsRNA disclosed herein has an apparent plasma clearance (CL / F) of at least 8.5 L / h. In some embodiments, the dsRNA has a CL / F within a range of 8.5 L / h to 18.5 L / h, 9 L / h to 18 L / h, 10 L / h to 17 L / h, or 11 L / h to 16 L / h. In some embodiments, the dsRNA has a CL / F of 8.5 L / h. In some embodiments, the dsRNA has a CL / F of 9 L / h. In some embodiments, the dsRNA has a CL / F of 10 L / h. In some embodiments, the dsRNA has a CL / F of 11 L / h. In some embodiments, the dsRNA has a CL / F of 12 L / h. In some embodiments, the dsRNA has a CL / F of 13 L / h. In some embodiments, the dsRNA has a CL / F of 14 L / h. In some embodiments, the dsRNA has a CL / F of 15 L / h.
[0094] In some embodiments, the geometric mean of the cumulative amount of drug excreted unchanged in urine in the 24 hours after administration (Aeu0-24) of a dsRNA agent described herein (e.g., QCZ484) is at least 10 mg (e.g., from 10 mg to 200 mg) . In some embodiments, the mean ratio of the unchanged urinary excretion of the drug relative to the dose in the 24 hours after administration (Feu0-24) of a dsRNA agent described herein (e.g., QCZ484) is at least 0.01, 0.02, 0.03, 0.04, or 0.05 (e.g., from 0.07 to 0.33) . In some embodiments, the Feu0-24 of a dsRNA agent described herein (e.g., QCZ484) is about 0.28, 0.29, 0.30, 0.31, 0.32, 0.33, 0.34, 0.35, 0.36, 0.37, 0.38, 0.39, 0.40, 0.41, 0.42, 0.43, 0.44, or 0.45.
[0095]
[0096] In some embodiments, the AGT dsRNA agents comprise one or more targeting or linking groups, which, in certain embodiments, are conjugated to the sense strand. The terms “targeting agent” , “linking agent” , “targeting compound” , and “targeting group” may be used interchangeably herein. A non-limiting example of a targeting group is a targeting group comprising an N-acetyl-galactosamine (GalNAc) . In certain embodiments, an AGT dsRNA agent comprises a targeting group conjugated to the 5'-end of the sense strand. In certain embodiments, an AGT dsRNA agent comprises a targeting group conjugated to the 3'-end of the sense strand. In some embodiments, the AGT dsRNA agent comprises a GalNAc-containing targeting group. In some embodiments, the targeting group comprises one GalNAc element. In some embodiments, the targeting group comprises more than one GalNAc element. In some embodiments, the targeting group comprises two GalNAc elements. In some embodiments, the targeting group comprises three GalNAc elements. In some embodiments, the targeting group comprises four GalNAc elements. In certain embodiments, the AGT dsRNA agent does not include a targeting group conjugated to one or both of the 3'-end and 5'-end of the sense strand. In certain embodiments, the AGT dsRNA agent does not include a GalNAc-containing targeting group conjugated to one or both of the 5'-end and the 3'-end of the sense strand. In some embodiments, the 3’ -end of the sense strand is conjugated to a targeting group comprising a GalNAc. In some embodiments, the 5’ -end of the sense strand is conjugated to a targeting group comprising a GalNAc. In some embodiments, the targeting group comprising a GalNAc is conjugated to an inverted abasic residue, and the inverted abasic residue is conjugated to the 3’ -end of the sense strand. In some embodiments, the targeting group comprising a GalNac is conjugated to an inverted abasic residue via a first phosphorothioate linkage, and the inverted abasic residue is conjugated to the 3’ -end of the sense strand via a second phosphorothioate linkage. In some embodiments, the targeting group comprising a GalNAc is conjugated to an inverted abasic residue, and the inverted abasic residue is conjugated to the 5’ -end of the sense strand. In some embodiments, the targeting group comprising a GalNac is conjugated to an inverted abasic residue via a first phosphorothioate linkage, and the inverted abasic residue is conjugated to the 5’ -end of the sense strand via a second phosphorothioate linkage.
[0097] In some embodiments, a targeting group provided herein may comprise a GalNac ligand attached to the rest of a dsRNA agent by a phosphodiester link (GLO) or a GalNAc ligand attached by a phosphorothioate link (GLS) . In some embodiments, the targeting group comprises one of the following structures:
[0098] In a preferred embodiments, the targeting group comprises GLS-15.
[0099] Additional targeting groups are known in the art, for example, targeting groups useful in certain embodiments include, but are not limited to, lipid moieties such as cholesterol moieties (Letsinger et al., Proc. Natl. Acid. Sci. USA, 1989, 86: 6553-6556) , cholic acid (Manoharan et al., Biorg. Med. Chem. Let., 1994, 4: 1053-1060) , thioethers, such as beryl-S-tritylthiol (Manoharan et al., Ann. NY Acad. Sci., 1992, 660: 306-309; Manoharan et al., Biorg. Med. Chem. Let., 1993, 3: 2765-2770 ) , thiocholesterols (Oberhauser et al., Nucl. Acids Res., 1992, 20: 533-538) , aliphatic chains such as dodecanediol or undecyl residues (Saison-Behmoaras et al., EMBO J, 1991, 10: 1111-1118; Kabanov et al., FEBS Lett., 1990, 259: 327-330; Svinarchuk et al., Biochimie, 1993, 75: 49-54) , phospholipids, such as 2-hexadecyl-rac-glycerol or triethylammonium 1, 2-di-O-hexadecyl-rac-glycerol-3-phosphonate (Manoharan et al., Tetrahedron Lett., 1995, 36: 3651-3654; Shea et al., Nucl. Acids Res., 1990, 18: 3777-3783) , polyamine or polyethylene glycol chains (Manoharan et al., Nucleosides &Nucleotides, 1995, 14: 969-973) or adamantane acetic acid (Manoharan et al., Tetrahedron Lett., 1995, 36: 3651-3654) , palmitoyl moieties (Mishra et al., Biochim. Biophys. Acta, 1995, 1264: 229-237) or octadecylamine or hexylamino-carbonyloxycholesterol moieties (Crooke et al., J. Pharmacol. Exp. Ther., 1996, 277: 923-937) .
[0100] A targeting group may be attached to an AGT dsRNA agent disclosed herein via a phosphodiester linkage (as in any of the exemplary GLO structures disclosed herein) , a phosphorothioate linkage (as in any of the exemplary GLS structures disclosed herein) , or another linking group.
[0101] The choice of targeting group may depend on the nature of the AGT-associated disease or condition, and the target cell type. In a non-limiting example, it may be desirable to target an AGT dsRNA agent to and / or into hepatocytes. In some embodiments, a therapeutic agent comprises an AGT dsRNA comprising a targeting group comprising a GalNAc. In some embodiments, the targeting group targets hepatocytes.
[0102] In some embodiments, the preferred dsRNA agent comprises a sense strand comprising the sequence and modifications of SEQ ID NO: 3 and an antisense strand comprising the sequence and modifications of SEQ ID NO: 4. QCZ484, also known as BW-00163, comprises a sense strand comprising the sequence and modifications (for example, nucleotide modifications (for example, 2’ -OMe and 2’ -F modified nucleotides) , thiophosphate linkages, inverted abasic residues, and conjugated targeting groups (for example, GLS-15) ) of SEQ ID NO: 3 and an antisense strand comprising the sequence and modifications (for example, nucleotide modifications (for example, 2’ -OMe and 2’ -F modified nucleotides) and thiophosphate linkages) of SEQ ID NO: 4, as depicted in Table 2. Table 2: Exemplary sense and antisense modified nucleotide sequences
[0103] Chemical modifications are indicated as: upper case: 2'-fluoro; lower case: 2'-OMe; phosphorothioate linkage: *; Invab = inverted abasic residue. It will be understood that each linkage that is not annotated is a phosphodiester linkage. In some embodiments, salts, mixed salts and / or free acid forms of dsRNA agents may be used in the methods disclosed herein. For example, in some embodiments a method described herein comprises administering (for example, administering to a subject in need thereof) a salt form of a dsRNA agent or a pharmaceutical composition comprising a salt form of a dsRNA agent. For example, in some embodiments described herein, a method for reducing serum AGT levels in a subject in need thereof comprises administering to the subject a salt form of a dsRNA agent. In some embodiments described herein, a method for reducing serum AGT levels in a subject in need thereof comprises administering to the subject a pharmaceutical composition comprising a salt form of a dsRNA agent. In some embodiments described herein, a method for treating a cardiovascular disease (e.g., ASCVD) in a subject in need thereof comprises administering to the subject a salt form of a dsRNA agent. In some embodiments described herein, a method for treating a cardiovascular disease (e.g., ASCVD) in a subject in need thereof comprises administering to the subject pharmaceutical composition comprising a salt form of a dsRNA agent. In some embodiments, the salt form is a sodium salt.
[0104] The free acid form of QCZ484 (shown below) has a molecular weight of 15, 698 Da and the molecular formula C498H668F8N165O314P43S7.
[0105] The sodium salt form of QCZ484 (shown below) has a molecular weight of 16, 643 Da and the molecular formula C498H625F8N165Na43O314P43S7.
[0106] In some embodiments a method described herein comprises administering (for example, administering to a subject in need thereof) a salt form of QCZ484 or a pharmaceutical composition comprising a salt form of QCZ484. For example, in some embodiments described herein, a method for reducing serum AGT levels in a subject in need thereof comprises administering to the subject a salt form of QCZ484. In some embodiments described herein, a method for reducing serum AGT levels in a subject in need thereof comprises administering to the subject a pharmaceutical composition comprising a salt form of QCZ484. In some embodiments described herein, a method for treating a cardiovascular disease (e.g., ASCVD) in a subject in need thereof comprises administering to the subject a salt form of QCZ484. In some embodiments described herein, a method for treating a cardiovascular disease (e.g., ASCVD) in a subject in need thereof comprises administering to the subject a pharmaceutical composition comprising a salt form of QCZ484.
[0107] In some embodiments, QCZ484 is prepared in a solution comprising 189 mg of QCZ484 in free acid form per 1 ml of solution. In some embodiments, QCZ484 is prepared in a solution comprising 200 mg of QCZ484 in sodium salt form per 1 ml of solution. Thus, in some embodiments described herein, a composition (for example, a pharmaceutical composition) comprises 189 mg QCZ484 in free acid form per ml. In some embodiments described herein, a composition (for example, a pharmaceutical composition) comprises 200 mg QCZ484 in sodium salt form per ml. Thus, in some embodiments, a method described herein comprises administering QCZ484 at a dose of 50-800 mg, wherein the QCZ484 is a salt form (for example, a sodium salt form) of QCZ484. In some embodiments, a method described herein comprises administering a composition (for example, a pharmaceutical composition) comprising QCZ484 at a dose of 50-800 mg, wherein the QCZ484 is a salt form (for example, a sodium salt form) of QCZ484. Thus, in some embodiments, a method described herein comprises administering a dose of at least 50 mg (e.g., 50 mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg, 600 mg, 650 mg, 700 mg, 750 mg, 800 mg) of a salt form (for example, a sodium salt form) of QCZ484. In some embodiments, a salt form (for example, a sodium salt form) of QCZ484 is administered at a dose of 50-300 mg, 50-200 mg, 50-150 mg, 100-300 mg, or 150-300 mg. In some embodiments, a salt form (for example, a sodium salt form) of QCZ484 is administered at a dose of 50 mg, 100 mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg, 600 mg, 650 mg, 700 mg, 750 mg, or 800 mg. In some embodiments, a salt form (for example, a sodium salt form) of QCZ484 is administered at a dose of 0.01-16 mg / kg patient body weight. C. Cardiovascular Disease
[0108] Without being bound to any particular theory, the instant inventors theorized that the reduction of AGT expression levels by one of the herein disclosed dsRNA agents may treat cardiovascular disease. In some embodiments, the cardiovascular disease is hypertension. In some embodiments, the cardiovascular disease is an atherosclerotic cardiovascular disease (ASCVD) . In some embodiments, the ASCVD comprises one or more of atherosclerosis, arteriosclerosis, coronary heart disease (CHD) , myocardial infarction, angina, coronary artery stenosis, a cerebrovascular disease, a transient ischemic attack, ischemic stroke, hemorrhagic stroke, heart failure, kidney failure, carotid artery stenosis, a peripheral artery disease, claudication, an aortic atherosclerotic disease, abdominal aortic aneurysm, and descending thoracic aneurysm. In some embodiments, the cardiovascular disease is a non-atherosclerotic cardiovascular disease. In some embodiments, the non-atherosclerotic cardiovascular disease comprises spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging and stress-induced cardiomyopathy (Takotsubo syndrome) , non-atherosclerotic peripheral artery disease, fibromuscular dysplasia (FMD) , spontaneous coronary artery dissection (SCAD) , a congenital coronary artery anomaly, coronary aneurysm, coronary arteritis, coronary artery dissection, coronary artery thrombosis without underlying atherosclerotic plaque (thrombosis in situ) , a coronary embola, a coronary fistula, a coronary ostia, a fixed luminal obstruction, aneurysm, aortic dissection, embolus, occlusive fibroelastois, supravalvular aortic stenosis with severe intimal thickening, syphilis, Takayasu disease, intimal fibrous proliferation, myocardial oxygen demand supply disproportion, a systemic metabolic disorder, Fabry disease, homocystinuria, Hunter and Hurler diseases, primary oxalosis, Sandhoff disease, and intramural coronary artery disease.
[0109] In some embodiments, a herein disclosed dsRNA agents is effective to treat vasculopathy, diabetic nephropathy, diabetic retinopathy, chronic heart failure, cardiomyopathy, diabetic cardiac myopathy, nocturnal hypotension, glomerulosclerosis, coarctation of the aorta, aortic aneurism, ventricular fibrosis, renal disease, systemic sclerosis, intrauterine growth restriction (IUGR) , fetal growth restriction, obesity, liver steatosis / fatty liver, non-alcoholic steatohepatitis (NASH) , non-alcoholic fatty liver disease (NAFLD) , glucose intolerance, type 2 diabetes, or a metabolic syndrome.
[0110] Hypertension is a complex multifactorial disease manifested by elevated blood pressure. Hypertension is the most prevalent manageable disease in developed countries, affecting 20-50%of the adult population. Hypertension is a major risk factor for a variety of diseases, disorders, and conditions, such as shortened life expectancy, chronic kidney disease, stroke, myocardial infarction, heart failure, aneurysm (e.g., aortic aneurysm) , peripheral artery disease, cardiac injury (for example, cardiac dilation or hypertrophy) and other cardiovascular-related diseases, disorders and / or conditions. Further, hypertension has been shown to be an important risk factor for cardiovascular morbidity and mortality, accounting for or constituting 62%of all strokes and 49%of all heart disease. In 2017, the guidelines for the diagnosis, prevention, and treatment of hypertension were changed to provide even lower blood pressure targets so as to further reduce the risk of developing hypertension-related diseases and disorders (see for example, Reboussin et al., Systematic Review for the 2017ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Nov 7. pii: S0735-1097 (17) 41517-8. doi: 10.1016 / j. jacc. 2017.11.004; and Whelton et al. (2017ACC / AHA / AAPA / ABC / ACPM / AGS / APhA / ASH / ASPC / NMA / PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017 Nov 7. pii: S0735-1097 (17) 41519-1. doi: 10.1016 / j. jacc. 2017.11.006) .
[0111] Without being bound by any particular theory, the instant inventors theorized that reduction of AGT levels by one of the disclosed dsRNA agents may treat hypertension. In some embodiments, the hypertension comprises high blood pressure, borderline hypertension, essential hypertension, secondary hypertension, isolated systolic or diastolic hypertension, gestational hypertension, diabetic hypertension, resistant hypertension, refractory hypertension, paroxysmal hypertension, renovascular hypertension, Goldblatt hypertension, ocular hypertension, glaucoma, pulmonary hypertension, portal hypertension, systemic venous hypertension, systolic hypertension, uncontrolled hypertension, and unstable hypertension. In some embodiments, the hypertension is mild to moderate hypertension. In some embodiments, mild to moderate hypertension is characterized by SBP of 140 to 179 mmHg and / or DBP of 90 to 109 mmHg. In some embodiments, the hypertension is mild hypertension. In some embodiments, mild hypertension is characterized by SBP of 140 to 159 mmHg and / or DBP of 90 to 99 mmHg. In some embodiments, the hypertension is moderate hypertension. In some embodiments, moderate hypertension is characterized by SBP of 160 to 179 mmHg and / or DBP of 100 to 109 mmHg.
[0112] In some embodiments the reduction of AGT levels by one of the disclosed dsRNA agents is effective to treat mild to moderate hypertension. In some embodiments, the reduction of AGT levels by one of the disclosed dsRNA agents is effective to treat a subject who has a mean sitting SBP level of ≥140 mmHg as measured by OBPM. In some embodiments, the reduction of AGT levels by one of the disclosed dsRNA agents is effective to treat a subject who has a mean 24 hour SBP level of between ≥130 and <160 mmHg as measured by ambulatory blood pressure monitoring (ABPM) . In some embodiments, the reduction of AGT levels by one of the disclosed dsRNA agents is effective to treat a subject who has a mean sitting SBP level of ≥140 mmHg as measured by OBPM and a mean 24 hour SBP level of between ≥130 and <160 mmHg as measured by ABPM. In some embodiments, the subject is not taking one or more anti-HTN medications. In some embodiments, the subject has undergone washout from one or more anti-HTN medications.
[0113] Based on the average of correctly measured seated blood pressure readings during two or more visits, a normotensive subject has a systolic blood pressure (SBP) of about 90-119 mmHg (about 12-15.9 kPa) and a diastolic blood pressure (DBP) of about 60-79 mmHg (about 8.0-10.5 kPa) . Subjects with prehypertension have SBP of about 120-139 mmHg (about 16.1-18.5 kPa) and DBP of about 60-79 mmHg (about 8.0-10.5 kPa) ; subjects with hypertension (e.g., stage I hypertension) have SBP of about 140-159 mmHg (about 18.7-21.2 kPa (kN / m2) ) and DBP of about 90-99 mmHg (about 12.0-13.2 kPa) ; subjects with hypertension (e.g., stage II hypertension) have SBP of about ≥160 mmHg (about ≥21.3 kPa) and DBP of about ≥100 mmHg (about ≥13.3 kPa) . D. Treatment
[0114] In various embodiments, the present disclosure provides a method comprising administering a dsRNA agent disclosed herein to reduce AGT levels. In some embodiments, a dsRNA agent disclosed herein is administered at a dose of at least 50 mg (e.g., 50 mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg, 600 mg, 650 mg, 700 mg, 750 mg, 800 mg) . In some embodiments, the dsRNA agent is administered at a dose of 50-800 mg. In some embodiments, the dsRNA agent is administered at a dose of 50-300 mg. In some embodiments, the dsRNA agent is administered at a dose of 50-200 mg. In some embodiments, the dsRNA agent is administered at a dose of 50-150 mg. In some embodiments, the dsRNA agent is administered at a dose of 100-300 mg. In some embodiments, the dsRNA agent is administered at a dose of 150-300 mg. In some embodiments, the dsRNA agent is administered at a 50 mg dose. In some embodiments, the dsRNA agent is administered at a 100 mg dose. In some embodiments, the dsRNA agent is administered at a 150 mg dose. In some embodiments, the dsRNA agent is administered at a 200 mg dose. In some embodiments, the dsRNA agent is administered at a 250 mg dose. In some embodiments, the dsRNA agent is administered at a 300 mg dose. In some embodiments, the dsRNA agent is administered at a 350 mg dose. In some embodiments, the dsRNA agent is administered at a 400 mg dose. In some embodiments, the dsRNA agent is administered at a 450 mg dose. In some embodiments, the dsRNA agent is administered at a 500 mg dose. In some embodiments, the dsRNA agent is administered at a 550 mg dose. In some embodiments, the dsRNA agent is administered at a 600 mg dose. In some embodiments, the dsRNA agent is administered at a 650 mg dose. In some embodiments, the dsRNA agent is administered at a 700 mg dose. In some embodiments, the dsRNA agent is administered at a 750 mg dose. In some embodiments, the dsRNA agent is administered at a 800 mg dose. In some embodiments, the dsRNA agent is administered at a dose of 0.01-16 mg / kg patient body weight.
[0115] In some embodiments, a dsRNA agent disclosed herein is administered only once. In some embodiments, a dsRNA agent disclosed herein is administered more than once. In some embodiments, a dsRNA agent disclosed herein is administered at a frequency of once every 6 months or less frequently (e.g., once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, once every 12 months, once every 13 months, once every 14 months, once every 15 months, once every 16 months, once every 17 months, or once every 18 months) . In some embodiments, the dsRNA agent is administered once every 6 months to once every 18 months. In some embodiments, the dsRNA agent is administered once every 6 months. In some embodiments, the dsRNA agent is administered once every 9 months. In some embodiments, the dsRNA agent is administered once every 12 months. In some embodiments, the dsRNA agent is administered once every 18 months.
[0116] Various factors can be considered when determining the dose and timing of delivery of the AGT dsRNA agents. The absolute amount of AGT dsRNA agent delivered will depend on a variety of factors, including co-treatment, number of doses, and individual subject parameters including age, physical condition, size, and weight.
[0117] An AGT dsRNA agent may be administered to a subject based on the medical condition of the individual subject. For instance, a subject to be treated may be diagnosed with ASCVD and / or hypertension. In some embodiments, a health care provider may evaluate AGT levels measured in a sample obtained from the subject and determine that it is desirable to reduce the subject’s AGT levels by administering an AGT dsRNA agent. In one non-limiting example, a biological sample, such as a blood or serum sample, can be obtained from a subject and the subject’s AGT level determined in the sample. In some embodiments, an AGT dsRNA agent is administered to a subject after obtaining a blood or serum sample, and then another sample is obtained from the subject after administration to compare AGT levels before and after administration. A decrease in a subject’s AGT levels in subsequent samples compared to pre-dose levels may be indicative of the efficacy of the administered AGT dsRNA agent. In such instance, a further dose may be administered. In one non-limiting example, blood pressure may be considered a physiological characteristic of an AGT-associated disorder, even if the subject has not been diagnosed with an AGT-associated disorder, such as those disclosed herein. A healthcare provider can monitor changes in a subject’s blood pressure as a measure of the efficacy of an administered AGT dsRNA agent.
[0118] In some embodiments, the methods disclosed herein treat a cardiovascular disease in a subject in need thereof, e.g., ASCVD. In some embodiments, treatment reduces serum AGT levels. In some embodiments, the method is effective to reduce serum AGT levels, e.g., reduce serum AGT levels by at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%, e.g., for at least 1-12 months, e.g., for at least one month, at least 3 months, at least 24 weeks, at least 6 months, at least 48 weeks, at least 12 months after administration of the dsRNA agent. In some embodiments, treatment reduces serum AGT levels by at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%, e.g., for at least 1-6 months, e.g., for at least one month, or preferably for at least 6 months after administration of the dsRNA agent. In some embodiments, treatment reduces serum AGT levels by at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, at least 95%, at least 96%, at least 97%, at least 98%, or at least 99%for at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 12 months, at least 48 weeks, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administration of the dsRNA agent. In some embodiments, the treatment reduces serum AGT levels by 50%to 95%, 60%to 95%, 70%to 95%, 80%to 95%, 85%to 95%, 85%to 99%, or 90%to 99%. In some embodiments, the method reduces hypertension in a subject in need thereof.
[0119] In some embodiments, treatment reduces serum AGT levels by 50%, 60%, 70%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99%, e.g., for 1-18 months, e.g., for one month, for 24 weeks, for 6 months, for 48 weeks, for 12 months, or for 18 months after administration of the dsRNA agent. In some embodiments, treatment reduces serum AGT levels by 50%, 60%, 70%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, 95%, 96%, 97%, 98%, or 99%, for 24 weeks, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 48 weeks, 12 months, 13 months, 14 months, 15 months, 16 months, 17 months, or 18 months after administration of the dsRNA agent.
[0120] In some embodiments, the methods described herein are effective to reduce serum AGT levels in a subject (e.g., a subject in need of treatment of a cardiovascular disease, e.g., ASCVD) . In some embodiments, the method reduces serum AGT levels by at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, or at least 95%, e.g., for at least 1-6 months, e.g., for at least one month, or preferably for at least 6 months after administration of the dsRNA agent. In some embodiments, the method reduces serum AGT levels by at least 50%, at least 60%, at least 70%, at least 80%, at least 85%, at least 90%, at least 91%, at least 92%, at least 93%, at least 94%, or at least 95%, for at least 24 weeks, at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 48 weeks, at least 12 months, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administration of the dsRNA agent.
[0121] In some embodiments, the method reduces serum AGT levels by 50%, 60%, 70%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, or 95%, e.g., for 1-18 months, e.g., for one month, for 6 months, for 12 months, or for 18 months after administration of the dsRNA agent. In some embodiments, the method reduces serum AGT levels by 50%, 60%, 70%, 80%, 85%, 90%, 91%, 92%, 93%, 94%, or 95%, for 24 weeks, 6 months, 7 months, 8 months, 9 months, 10 months, 11 months, 48 weeks, 12 months, 13 months, 14 months, 15 months, 16 months, 17 months, or 18 months after administration of the dsRNA agent.
[0122] In some embodiments, the method reduces serum AGT level by at least 80% (e.g., ≥80%, ≥85%, ≥90%, ≥95%) compared to baseline serum AGT level by at least 22-29 days after administration (e.g., by 22 days, by 29 days, by 30 days after administration) , and the serum AGT level is maintained at 50%or less (e.g., ≤50%, ≤60%, ≤70%, ≤80%) of baseline for at least 24 weeks (e.g., 24 weeks, 36 weeks, 48 weeks) after administration. In some embodiments, the method reduces serum AGT level by ≥90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤80%of baseline for at least 24 weeks after administration. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤80%of baseline for at least 24 weeks after administration, wherein the method comprises administering a single 150 mg dose of a dsRNA agent disclosed herein. In some embodiments, the method reduces a serum AGT level by 90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤50%of baseline for at least 48 weeks after administration. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤50%of baseline for at least 48 weeks after administration, wherein the method comprises administering a single 150 mg dose of a dsRNA agent disclosed herein. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤50%of baseline for at least 48 weeks after administration, wherein the method comprises administering a single 300 mg dose of a dsRNA agent disclosed herein. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 22 days after administration, and the serum AGT level is maintained at ≤50%of baseline for at least 48 weeks after administration. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 22 days after administration, and the serum AGT level is maintained at ≤50%of baseline for at least 48 weeks after administration, wherein the method comprises administering a single 300 mg dose of a dsRNA agent disclosed herein. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline by 29 days after administration, and the serum AGT level is maintained at ≤80%of baseline for at least 48 weeks after administration. In some embodiments, the method reduces a serum AGT level by ≥90%compared to baseline serum AGT level by 29 days after administration, and the serum AGT level is maintained at ≤80%of baseline for at least 48 weeks after administration, wherein the methods comprise administering a single 300 mg dose of a dsRNA disclosed herein.
[0123] In some embodiments, the effect of the dsRNA agent on blood pressure is measured by ambulatory blood pressure monitoring (ABPM) . ABPM may involve the use of a 24-hour ABPM monitoring device to monitor a subject’s blood pressure throughout the day (e.g., for about 24 hours) . In some embodiments, the ABPM monitoring device records the subject’s blood pressure periodically throughout the day, e.g., every hour, e.g., every half hour, e.g., every twenty minutes during the day and every thirty minutes during the night. In some embodiments, the ABPM device is attached to the non-dominant arm of the subject. In some embodiments, the ABPM device is attached to the dominant arm of the subject. In some embodiments, the ABPM device is used for one month, two months, three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more months after administration of a dsRNA agent. In some embodiments, the ABPM device is attached to the subject three months, six months, or twelve months after administration of a dsRNA agent.
[0124] In some embodiments, the effect of the dsRNA agent on blood pressure is measured by office blood pressure measurement (OBPM) . OBPM may involve a healthcare professional recording a subject’s blood pressure. In some embodiments, the OBPM measures the subject’s blood pressure in the non-dominant arm. In some embodiments, the OBPM measures the subject’s blood pressure in the dominant arm. In some embodiments, more than one OBPM measurement is taken over a period of time. In some embodiments, the more than one OBPM measurements are taken at the same time of day, using the same equipment, and / or with the same healthcare professional. In some embodiments, the OBPM is taken while the subject is in a relaxed setting and / or at least five minutes with the subjects back supported and both feet placed on the floor. In some embodiments, the OBPM is taken three times with about one minute between measurements.
[0125] In some embodiments, the effect of the dsRNA agent on blood pressure is measured by home blood pressure measurement (HBPM) . HBPM may involve a subject recording their own blood pressure using a blood pressure measurement device. In some embodiments, the HBPM is taken in a sitting position after sitting for at least five minutes in a quiet environment. In some embodiments, the HBPM is taken three times with about one minute between measurements.
[0126] In some embodiments, the blood pressure measurement is a day-time blood pressure measurement. In some embodiments, the blood pressure measurement is a night-time blood pressure measurement. In some embodiments, the reduction in SBP and / or DBP does not differ during a day-time blood pressure measurement and a night-time blood pressure measurement. Without being bound by any particular theory, it is contemplated herein that the blood pressure lowering effects of a dsRNA disclosed herein during night-time are advantageous for managing nocturnal hypertension because night-time blood pressure is a stronger predictor of future cardiovascular and kidney events. In some embodiments, the blood pressure measurement is a mean 24 hour blood pressure measurement, wherein the mean is an average of at least two blood pressure measurements taken over a 24 hour period, e.g., using an ABPM monitoring device. In some embodiments, the blood pressure measurement is a time-adjusted mean blood pressure measurement, wherein the time-adjusted mean measurement is adjusted depending on the time of day when the measurements in the series are taken from the subject.
[0127] In some embodiments, a method of treating a cardiovascular disease disclosed herein reduces the subject’s SBP as compared to the subject’s SBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s SBP when measured at least at 2 different timepoints after administration compared to the subject’s SBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s SBP in the absence of treatment.
[0128] In some embodiments, a method of treating a cardiovascular disease disclosed herein reduces the subject’s mean 24 hour SBP, e.g., as assessed by ABPM compared to the subject’s mean 24 hour SBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP, e.g., as assessed by ABPM, at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s mean 24 hour SBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP, e.g., as assessed by ABPM, when measured at least at 2 different timepoints, as compared to the subject’s mean 24 hour SBP in the absence of treatment.
[0129] In some embodiments, the method of treating cardiovascular disease reduces a subject’s DBP compared to the subject’s DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s DBP when measured at least at 2 different timepoints after administration compared to the subject’s DBP in the absence of treatment. In some embodiments, the method of treating cardiovascular disease reduces a subject’s DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the 24 hour DBP, e.g., as assessed by ABPM, compared to the subject’s 24 hour DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the 24 hour DBP, e.g., as assessed by ABPM, at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s 24 hour DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour DBP, e.g., as assessed by ABPM, when measured at least at 2 different timepoints after administration compared to the subject’s DBP in the absence of treatment.
[0130] In some embodiments, the method of treating a cardiovascular disease reduces the subject’s SBP and DBP compared to the subject’s SBP and DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s SBP and DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s SBP and DBP in the absence of treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s SBP and DBP when measured at least at 2 different timepoints after administration compared to the subject’s SBP and DBP in the absence of treatment.
[0131] In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline mean 24 hour SBP. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg, relative to the subject’s baseline mean 24 hour SBP. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by about 10 mmHg, about 15 mmHg, about 20 mmHg, about 25 mmHg, or about 30 mmHg, relative to the subject’s baseline mean 24 hour SBP.
[0132] In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0133] In some embodiments, the method of treating a cardiovascular disease reduces the mean 24 hour SBP from baseline as assessed by ABPM at 3 months after treatment. In some embodiments, the method of treating a cardiovascular disease reduces the mean 24 hour SBP by at least 10 mmHg as assessed by ABPM at 3 months after treatment. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP from baseline as assessed by ABPM at 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg as assessed by ABPM at 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP by at least 10 mmHg from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg and reduces SBP by at least 10 mmHg from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration.
[0134] In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean SBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces time-adjusted mean SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time SBP, e.g., as assessed by ABPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time DBP, e.g., as assessed by ABPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time SBP and / or DBP, e.g., as assessed by ABPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces day-time and night-time SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and DBP from baseline, e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and DBP, e.g., as assessed by HBPM, at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, e.g., at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP, e.g., at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 10 mmHg, e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 12 months after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces DBP by at least 10 mmHg, e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, the method of treating a cardiovascular disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM, at 48 weeks after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration. In some embodiments, the method is effective to reduce SBP, e.g., is effective to reduce SBP by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or is effective to reduce DPB, e.g., reduce DBP by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration. In some embodiments, SBP is reduced by 10 mmHg, 11 mmHg, 12 mmHg, 13 mmHg, 14 mmHg, 15 mmHg, 16 mmHg, 17 mmHg, 18 mmHg, 19 mmHg, or 20 mmHg and DBP is reduced by 1 mmHg, 2 mmHg, 3 mmHg, 4 mmHg, 5 mmHg, 6 mmHg, 7 mmHg, 8 mmHg, 9 mmHg, or 10 mmHg by at least 4 weeks after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg to 15 mmHg, or 10 mmHg to 20 mmHg and DBP is reduced by 1 mmHg to 5 mmHg, or 5 mmHg to 10 mmHg by at least 4 weeks after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg, 11 mmHg, 12 mmHg, 13 mmHg, 14 mmHg, 15 mmHg, 16 mmHg, 17 mmHg, 18 mmHg, 19 mmHg, or 20 mmHg and DBP is reduced by 1 mmHg, 2 mmHg, 3 mmHg, 4 mmHg, 5 mmHg, 6 mmHg, 7 mmHg, 8 mmHg, 9 mmHg, or 10 mmHg from at least 4 weeks after administration through at least 6 months as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg to 15 mmHg, or 10 mmHg to 20 mmHg and DBP is reduced by 1 mmHg to 5 mmHg, or 5 mmHg to 10 mmHg from at least 4 weeks after administration through at least 6 months after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg, 11 mmHg, 12 mmHg, 13 mmHg, 14 mmHg, 15 mmHg, 16 mmHg, 17 mmHg, 18 mmHg, 19 mmHg, or 20 mmHg and DBP is reduced by 1 mmHg, 2 mmHg, 3 mmHg, 4 mmHg, 5 mmHg, 6 mmHg, 7 mmHg, 8 mmHg, 9 mmHg, or 10 mmHg at 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, or 52 weeks after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg to 15 mmHg, or 10 mmHg to 20 mmHg at 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, or 52 weeks after administration as measured by 24-hr ABPM and DBP is reduced by 1 mmHg to 5 mmHg, or 5 mmHg to 10 mmHg at 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, or 52 weeks after administration after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg to 15 mmHg, or 10 mmHg to 20 mmHg at 40 weeks after administration as measured by 24-hr ABPM and DBP is reduced by 1 mmHg to 5 mmHg, or 5 mmHg to 10 mmHg at 48 weeks after administration after administration as measured by 24-hr ABPM. In some embodiments, SBP is reduced by 10 mmHg to 15 mmHg, or 10 mmHg to 20 mmHg at 48 weeks after administration as measured by 24-hr ABPM and DBP is reduced by 1 mmHg to 5 mmHg, or 5 mmHg to 10 mmHg at 48 weeks after administration after administration as measured by 24-hr ABPM. In some embodiments, the SBP and / or DBP is a day-time blood pressure measurement. In some embodiments, the SBP and / or DBP is a night-time blood pressure measurement. In some embodiments, the method of treating a cardiovascular disease reduces circulating AGT from baseline. In some embodiments, the method of treating a cardiovascular disease reduces RAAS-related signaling pathway activity from baseline. In some embodiments, the method of treating a cardiovascular disease does not form anti-QCZ484 antibodies.
[0135] In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce serum AGT levels as compared to the subject’s baseline serum AGT levels. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce serum AGT levels as compared to the subject’s baseline serum AGT levels as measured by ELISA. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce blood pressure as compared to the subject’s baseline blood pressure. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce blood pressure as compared to the subject’s baseline blood pressure as measured by ABPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce SBP as compared to the subject’s baseline SBP as measured by ABPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce DBP as compared to the subject’s baseline DBP as measured by ABPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce blood pressure as compared to the subject’s baseline blood pressure as measured by OBPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce SBP as compared to the subject’s baseline SBP as measured by OBPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce DBP as compared to the subject’s baseline DBP as measured by OBPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce blood pressure as compared to the subject’s baseline blood pressure as measured by HBPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce SBP as compared to the subject’s baseline SBP as measured by HBPM. In some embodiments, the administration of the dsRNA agent to a subject is effective to reduce DBP as compared to the subject’s baseline DBP measured by HBPM.
[0136] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP as assessed by ABPM compared to the subject’s baseline 24 hour SBP as assessed by ABPM. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s baseline 24 hour SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP as assessed by ABPM when measured at least at 2 different timepoints compared to the subject’s baseline 24 hour SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP compared to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP at 3 months after administration compared to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP when measured at least at 2 different timepoints compared to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour DBP as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the administration of dsRNA agent is effective to reduce the subject’s mean 24 hour DBP as assessed by ABPM when measured at least at 2 different timepoints compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP compared to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP when measured at least at 2 different timepoints compared to the subject’s baseline DBP. In some embodiments, the administration of dsRNA agent is effective to reduce the subject’s SBP and DBP after administration compared to the subject’s baseline SBP and DBP. In some embodiments, the administration of dsRNA agent is effective to reduce the subject’s SBP and DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or at 24 or 48 or more weeks) after administration compared to the subject’s baseline SBP and DBP. In some embodiments, the administration of dsRNA agent is effective to reduce the subject’s SBP and DBP when measured at least at two different timepoints compared to the subject’s baseline SBP and DBP.
[0137] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP to less than 140 mmHg, less than 135 mmHg, less than 130 mmHg, less than 125 mmHg, less than 120 mmHg, less than 115 mmHg, or less than 110 mmHg. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP to a range from 90 mmHg to 140 mmHg, from 90 mmHg to 135 mmHg, from 90 mmHg to 130 mmHg, from 90 mmHg to 125 mmHg, from 90 mmHg to 120 mmHg, from 90 mmHg to 115 mmHg, from 90 mmHg to 110 mmHg, from 100 mmHg to 140 mmHg, from 100 mmHg to 135 mmHg, from 100 mmHg to 130 mmHg, from 100 mmHg to 125 mmHg, from 100 mmHg to 120 mmHg, from 100 mmHg to 115 mmHg, from 100 mmHg to 110 mmHg, from 110 mmHg to 140 mmHg, from 110 mmHg to 135 mmHg, from 110 mmHg to 130 mmHg, from 110 mmHg to 125 mmHg, from 110 mmHg to 120 mmHg, or from 110 mmHg to 115 mmHg. In some embodiments, the effect of the dsRNA agent on blood pressure is measured by taking a subject’s blood pressure at baseline, then taking the subject’s blood pressure again after administration of the dsRNA agent. In some embodiments, the subject’s blood pressure is taken one month, two months, three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months after administration of the dsRNA agent. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP by at least 5 mmHg, at least 6 mmHg, at least 7 mmHg, at least 8 mmHg, at least 9 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, or at least 25 mmHg relative to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) compared to the subject’s baseline and to reduce the subject’s DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) compared to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, or 20 mmHg to 25 mmHg relative to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg compared to the subject’s baseline and to reduce the subject’s DBP by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, or 20 mmHg to 25 mmHg compared to the subject’s baseline DBP.
[0138] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to 130 mmHg.
[0139] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP to less than 130 mmHg (e.g., <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0140] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, forty-eight weeks, or more than twelve months) after administration by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline mean 24 hour DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline mean 24 hour DBP.
[0141] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour DBP by at least 5 mmHg (e.g., at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, from 5 mmHg to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0142] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to 120 mmHg.
[0143] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) when measured at least at 2 different timepoints (e.g., at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months) after administration to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 90 mmHg to 120 mmHg.
[0144] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, wherein SBP is reduced to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to 130 mmHg, and DBP is reduced to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg.
[0145] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP to less than 130 mmHg (<130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) and the subjects DBP to less than 120 mmHg (e.g., <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0146] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, wherein SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, wherein SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP.
[0147] In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s SBP by at least 10 mmHg (e.g., at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) and DBP by at least 5 mmHg (e.g., at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0148] In some embodiments described herein, the SBP is a daytime SBP. In some embodiments described herein, the SBP is a nighttime SBP. In some embodiments described herein, the DBP is a daytime DBP. In some embodiments described herein, the DBP is a nighttime DBP.
[0149] In some embodiments, the administration of the dsRNA agent is effective to reduce the mean 24 hour SBP from baseline as assessed by ABPM at 3 months after treatment. In some embodiments, the administration of the dsRNA agent is effective to reduce the mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 3 months after treatment. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP from baseline as assessed by ABPM at 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., from 70 mmHg to 130 mmHg) as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., from 70 mmHg to 130 mmHg) and reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration.
[0150] In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce time-adjusted mean SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time SBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time SBP and / or DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce day-time and night-time SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / orOBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce circulating AGT from baseline. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration. In some embodiments, the administration of the dsRNA agent is effective to reduce RAAS-related signaling pathway activity from baseline. In some embodiments, administration of the dsRNA agent does not form anti-QCZ484 antibodies.
[0151] In various embodiments, the instant application provides compositions comprising an AGT dsRNA agent disclosed herein for use in treating an AGT-associated disease. In some embodiments, the compositions comprising an AGT dsRNA agent also comprises an excipient. In some embodiments, the compositions are for use in treating a cardiovascular disease, e.g., ASCVD. In some embodiments, the compositions are for use in treating hypertension.
[0152] In some embodiments, the composition used in a method disclosed herein, e.g., for use in treating a cardiovascular disease, e.g., ASCVD, comprises a dsRNA agent comprising a sense strand comprising a sequence having at least 95%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 95%identity to SEQ ID NO: 2. In some embodiments, the composition comprises a dsRNA agent comprising a sense strand comprising a sequence having at least 99%identity to SEQ ID NO: 1 and an antisense stand comprising a sequence having at least 99%identity to SEQ ID NO: 2. In some embodiments, the composition comprises a dsRNA agent comprising a sense strand comprising SEQ ID NO: 1. In some embodiments, the composition comprises a dsRNA agent comprising an antisense strand comprising SEQ ID NO: 2. In some embodiments, the composition comprises a dsRNA agent comprising a sense strand consisting of SEQ ID NO: 1 and an antisense strand consisting of SEQ ID NO: 2. In some embodiments, the composition comprises a dsRNA agent comprising a sense strand comprising the sequence and modifications of SEQ ID NO: 3 and an antisense strand comprising the sequence and modifications of SEQ ID NO: 4.
[0153] In some embodiments, the composition used in a method disclosed herein, e.g., for use in treating a cardiovascular disease, e.g., ASCVD, comprises a dose of at least 50 mg (e.g., 50 mg, 150 mg, 200 mg, 250 mg, 300 mg, 350 mg, 400 mg, 450 mg, 500 mg, 550 mg, 600 mg, 650 mg, 700 mg, 750 mg, 800 mg) of the dsRNA agent. In some embodiments, the dose is 50-800 mg. In some embodiments, the dose is 50 mg. In some embodiments, the dose is 100 mg. In some embodiments, the dose is 150 mg. In some embodiments, the dose is 300 mg. In some embodiments, the dose is 600 mg.
[0154] In some embodiments, the composition used in a method disclosed herein, e.g., for use in treating a cardiovascular disease, e.g., ASCVD, is administered only once. In some embodiments, the composition is administered more than once. In some embodiments, the composition is administered at a frequency of once every 6 months or less (e.g., once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, once every 12 months, once every 13 months, once every 14 months, once every 15 months, once every 16 months, once every 17 months, or once every 18 months) . In some embodiments, the composition is administered once every 6 months to once every 18 months. In some embodiments, the composition is administered once every 6 months. In some embodiments, the composition is administered once every 9 months. In some embodiments, the composition is administered once every 12 months. In some embodiments, the composition is administered once every 18 months.
[0155] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s serum AGT levels compared to the subject’s baseline serum AGT levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour SBP, e.g., as assessed by ABPM, compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration, e.g., as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour SBP when measured at least at 2 different timepoints, e.g., as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour DBP, e.g., as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration, e.g., as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces a subject’s mean 24 hour DBP when measured at least at 2 different timepoints, e.g., as assessed by ABPM compared to the subject’s mean baseline 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s DBP compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s DBP when measured at least at 2 different timepoints when compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and / or DBP compared to a subject’s baseline SBP and / or DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and / or DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP and DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and / or DBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP and / or DBP in the absence of treatment.
[0156] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s serum AGT levels by at least 70%, by at least 75%, by at least 80%, by at least 85%, or by at least 90%relative to the subject’s baseline AGT serum levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s serum AGT levels by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%relative to the subject’s baseline AGT serum levels.
[0157] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline mean 24 hour SBP.
[0158] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0159] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration, e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to 130 mmHg.
[0160] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP to less than 130 mmHg (e.g., <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0161] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration, e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline mean 24 hour DBP.
[0162] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24 hour DBP by at least 5 mmHg (e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0163] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to 120 mmHg.
[0164] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0165] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, or <90 mmHg and DBP is reduced to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or <80 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein the subject’s SBP is reduced to a range from 90 mmHg to 130 mmHg, from 90 mmHg to 125 mmHg, from 90 mmHg to 120 mmHg, from 90 mmHg to 115 mmHg, from 90 mmHg to 110 mmHg, from 90 mmHg to 100 mmHg, from 100 mmHg to 130 mmHg, from 100 mmHg to 125 mmHg, from 100 mmHg to 120 mmHg, from 100 mmHg to 115 mmHg, from 100 mmHg to 110 mmHg, from 110 mmHg to 130 mmHg, from 110 mmHg to 125 mmHg, from 110 mmHg to 120 mmHg, or from 110 mmHg to 115 mmHg and / or the subject’s DBP is reduced to a range from 80 mmHg to 120 mmHg, from 80 mmHg to 115 mmHg, from 80 mmHg to 110 mmHg, from 80 mmHg to 105 mmHg, from 80 mmHg to 100 mmHg, from 80 mmHg to 90 mmHg, from 90 mmHg to 120 mmHg, from 90 mmHg to 115 mmHg, from 90 mmHg to 110 mmHg, from 90 mmHg to 105 mmHg, from 90 mmHg to 100 mmHg, from 100 mmHg to 120 mmHg, from 100 mmHg to 115 mmHg, from 100 mmHg to 110 mmHg, or from 100 mmHg to 105 mmHg.
[0166] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP to less than 130 mmHg (e.g., <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) and DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0167] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP.
[0168] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s SBP by at least 10 mmHg (e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) and DBP by at least 5 mmHg (e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0169] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the mean 24-hour SBP from baseline, e.g as assessed by ABPM at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the mean 24-hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 3 months after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24-hour SBP from baseline as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces the subject’s mean 24-hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., 70 mmHg to 130 mmHg) as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., 70 mmHg to 130 mmHg) and reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration.
[0170] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces time-adjusted mean SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time SBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time SBP and / or DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces day-time and night-time SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and DBP as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, the composition comprises an amount of the dsRNA agent effective to reduce SBP, e.g., an amount of dsRNA agent effective to reduce SBP by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or comprises an amount of the dsRNA agent effective to reduce DBP, e.g., an amount of dsRNA agent effective to reduce DBP by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., after 3 months, after 24 weeks, after 6 months, after 48 weeks and / or 12 months after administration. In some embodiments, SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces circulating AGT from baseline. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease reduces RAAS-related signaling pathway activity from baseline. In some embodiments, administration of the composition comprising an AGT dsRNA agent for use in treating an AGT-associated disease does not form anti-QCZ484 antibodies.
[0171] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s serum AGT levels compared to the subject’s baseline serum AGT levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour SBP as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration as assessed by ABPM compared to the subject’s mean baseline 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour SBP when measured at least at 2 different timepoints as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour DBP as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces a subject’s mean 24 hour DBP when measured at least at 2 different timepoints as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP when measured at least at 2 different timepoints when compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP compared to a subject’s baseline SBP and DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP and DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP and DBP.
[0172] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s serum AGT levels by at least 70%, by at least 75%, by at least 80%, by at least 85%, or by at least 90%relative to the subject’s baseline AGT serum levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s serum AGT levels by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%relative to the subject’s baseline AGT serum levels. In some embodiments, the reduction in serum AGT levels is achieved by 29 days after administration. In some embodiments, the reduction in serum AGT levels is maintained for at least 24 weeks, at least 6 months, at least 36 weeks, at least 9 months, at least 48 weeks, at least 12 months, or at least 52 weeks after administration.
[0173] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration, e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration, e.g., from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline mean 24 hour SBP.
[0174] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0175] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to 130 mmHg.
[0176] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP to less than 130 mmHg (e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0177] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline mean 24 hour DBP.
[0178] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour DBP by at least 5 mmHg (e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0179] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or <80 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration from 80 mmHg to 120 mmHg.
[0180] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0181] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, or <90 mmHg and DBP is reduced to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or <80 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced to 90 mmHg to 130 mmHg and DBP is reduced to 80 mmHg to 120 mmHg.
[0182] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP to less than 130 mmHg (e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) and DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0183] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, six months, seven months, eight months, nine months, ten months, eleven months, twelve months, or more than twelve months) after administration, wherein SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, wherein SBP is reduced by from 10 mmHg to 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by from 5 mmHg to 40 mmHg relative to the subject’s baseline DBP.
[0184] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) and mean 24 hour DBP by at least 5 mmHg (e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0185] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the mean 24 hour SBP from baseline as assessed by ABPM at 3 months after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 3 months after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP from baseline as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., from 90 to <130 mmHg) as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating a cardiovascular disease achieves SBP less than 130 mmHg (e.g., 90 mmHg to <130 mmHg) and reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 5 mmHg as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 10 mmHg as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration.
[0186] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean SBP and DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces time-adjusted mean SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time SBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time SBP and / or DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces day-time and night-time SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and DBP, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by from 10 mmHg to 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by from 5 mmHg to 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHG) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces circulating AGT from baseline. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease reduces RAAS-related signaling pathway activity from baseline. In some embodiments, administration of the composition comprising an AGT dsRNA agent for use in treating a cardiovascular disease does not form anti-QCZ484 antibodies.
[0187] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s serum AGT levels compared to the subject’s baseline serum AGT levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour SBP as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour SBP when measured at least at 2 different timepoints as assessed by ABPM compared to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour DBP as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces a subject’s mean 24 hour DBP when measured at least at 2 different timepoints as assessed by ABPM compared to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP when measured at least at 2 different timepoints when compared to a subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP compared to a subject’s baseline SBP and DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP at 3 months or more (e.g., 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 or more months, or 24 or 48 or more weeks) after administration compared to a subject’s baseline SBP and DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP when measured at least at 2 different timepoints when compared to a subject’s baseline SBP and DBP.
[0188] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s serum AGT levels by at least 70%, by at least 75%, by at least 80%, by at least 85%, or by at least 90%relative to the subject’s baseline AGT serum levels. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s serum AGT levels by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%relative to the subject’s baseline AGT serum levels. In some embodiments, the reduction in serum AGT levels is achieved by 29 days after administration. In some embodiments, the reduction in serum AGT levels is maintained for at least 24 weeks, at least 6 months, at least 36 weeks, at least 9 months, at least 48 weeks, at least 12 months, or at least 52 weeks after administration.
[0189] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline mean 24 hour SBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour SBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., by from 10 mmHg to 30 mmHg relative to the subject’s baseline mean 24 hour SBP.
[0190] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, or from 10 mmHg to 30 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0191] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, or <90 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration to from 90 mmHg to 130 mmHg.
[0192] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP to less than 130 mmHg (e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0193] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline mean 24 hour DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour DBP as assessed by ABPM at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline mean 24 hour DBP.
[0194] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour DBP by at least 5 mmHg (e.g., by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, at least 40 mmHg, or from 5 mmHg to 40 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0195] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or <80 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., from 80 mmHg to 120 mmHg.
[0196] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0197] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, or <90 mmHg and DBP is reduced to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or <80 mmHg. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced to 80 mmHg to 130 mmHg and DBP is reduced to 80 mmHg to 120 mmHg.
[0198] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP to less than 130 mmHg (e.g., to <130 mmHg, <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, or from 90 mmHg to <130 mmHg) and DBP to less than 120 mmHg (e.g., to <120 mmHg, <110 mmHg, <100 mmHg, <90 mmHg, <80 mmHg, or from 80 mmHg to <120 mmHg) when comparing at least 2 different timepoints after administration (e.g., comparing baseline to 2 or more months of treatment, at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months after administration) as assessed by ABPM, HBPM, and / or OBPM. In some embodiments, the at least 2 different timepoints after administration are taken at least 2 months apart. In some embodiments, the at least 2 different timepoints after administration are taken at least 3 months apart.
[0199] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (for example, as assessed by HBPM, ABPM and / or OBPM) at 3 months or more (e.g., three months, four months, five months, twenty-four weeks, six months, seven months, eight months, nine months, ten months, eleven months, forty-eight weeks, twelve months, or more than twelve months) after administration, e.g., wherein SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP.
[0200] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (e.g., at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months) after administration wherein SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, wherein the measurements are taken at least 2 months apart. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s SBP and DBP (e.g., at 2 months and 4 months, 3 months and 6 months, 4 months and 7 months, 5 months and 8 months, 6 months and 9 months, 7 months and 10 months, 8 months and 11 months, or 9 months and 12 months) after administration wherein SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP and DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP, wherein the measurements are taken at least 2 months apart.
[0201] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the mean 24 hour SBP from baseline as assessed by ABPM at 3 months after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 3 months after treatment. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour SBP from baseline as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces the subject’s mean 24 hour SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM at 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by OBPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating hypertension achieves SBP less than 130 mmHg (e.g., from 90 mmHg to <180 mmHg) as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the method of treating hypertension achieves SBP less than 130 mmHg (e.g., from 90 mmHg to <130 mmHg) and reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 5 mmHg as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration.
[0202] In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean SBP and DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces time-adjusted mean SBP and DBP e.g., as assessed by ABPM and / or OBPM at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP and / or DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months or 6 months after administration. In some embodiments, SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP and / or DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time SBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time SBP and / or DBP, e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces day-time and night-time SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and DBP from baseline, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and DBP, e.g., as assessed by HBPM at 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, or at least 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by at least 5 mmHg, at least 10 mmHg, at least 15 mmHg, at least 20 mmHg, at least 25 mmHg, at least 30 mmHg, at least 35 mmHg, or at least 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, SBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 15 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, or 25 mmHg to 30 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by from 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, 1 mmHg to 15 mmHg, 5 mmHg to 10 mmHg, 5 mmHg to 15 mmHg, 5 mmHg to 20 mmHg, 5 mmHg to 25 mmHg, 5 mmHg to 30 mmHg, 5 mmHg to 35 mmHg, 5 mmHg to 40 mmHg, 10 mmHg to 15 mmHg, 10 mmHg to 20 mmHg, 10 mmHg to 25 mmHg, 10 mmHg to 30 mmHg, 10 mmHg to 35 mmHg, 10 mmHg to 40 mmHg, 15 mmHg to 20 mmHg, 15 mmHg to 25 mmHg, 15 mmHg to 30 mmHg, 15 mmHg to 35 mmHg, 15 mmHg to 40 mmHg, 20 mmHg to 25 mmHg, 20 mmHg to 30 mmHg, 20 mmHg to 35 mmHg, 20 mmHg to 40 mmHg, 25 mmHg to 30 mmHg, 25 mmHg to 35 mmHg, 25 mmHg to 40 mmHg, 30 mmHg to 35 mmHg, 30 mmHg to 40 mmHg, or 35 mmHg to 40 mmHg relative to the subject’s baseline DBP, e.g., after 3 months and / or 6 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 5 mmHg (e.g., from 5 mmHg to 10 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and / or DBP from baseline, e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces SBP and / or DBP by at least 10 mmHg (e.g., from 10 mmHg to 20 mmHg) , e.g., as assessed by ABPM and / or OBPM at 48 weeks after administration. In some embodiments, SBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline SBP, and / or DBP is reduced by 1 mmHg to 5 mmHg, 1 mmHg to 6 mmHg, 1 mmHg to 7 mmHg, 1 mmHg to 8 mmHg, 2 mmHg to 8 mmHg, 1 mmHg to 9 mmHg, 1 mmHg to 10 mmHg, or 1 mmHg to 15 mmHg relative to the subject’s baseline DBP, e.g., at 48 weeks and / or 12 months after administration. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces circulating AGT from baseline. In some embodiments, the composition comprising an AGT dsRNA agent for use in treating hypertension reduces RAAS-related signaling pathway activity from baseline. In some embodiments, administration of the composition comprising an AGT dsRNA agent for use in treating hypertension does not form anti-QCZ484 antibodies.
[0203] In some embodiments, the efficacy of treatment can be assessed by measuring one or more biomarkers. In some embodiments, the biomarkers comprise components of the RAAS signaling pathway such as AGT, renin, angiotensin 1, angiotensin 2, and / or aldosterone. These biomarkers can be evaluated using methods known in the art such as ELISA. In some embodiments, the circulating level of one or more components of the RAAS signaling pathway (e.g., AGT, renin, angiotensin 1, angiotensin 2, or aldosterone) is reduced by 50%, 60%, 70%, 80%, 90%, 95%, or more compared to baseline. In some embodiments, the level of activity of one or more circulating components of the RAAS signaling pathway (e.g., AGT, renin, angiotensin 1, angiotensin 2, or aldosterone) is reduced by 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline. In some embodiments, a method described herein is effective to reduce the circulating level of one or more components of the RAAS signaling pathway (e.g., AGT, renin, angiotensin 1, angiotensin 2, or aldosterone) by 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline. In some embodiments, a method described herein is effective to reduce the level of activity of one or more circulating components of the RAAS signaling pathway (e.g., AGT, renin, angiotensin 1, angiotensin 2, or aldosterone) by 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline. In some embodiments, the circulating level of one or more components of the RAAS signaling pathway and / or the level of activity of one or more circulating components of the RAAS signaling pathway is evaluated by ELISA. In some embodiments, the reduction in the circulating level of one or more components of the RAAS signaling pathway and / or the level of activity of one or more circulating components of the RAAS signaling pathway is achieved by 29 days after administration. In some embodiments, the reduction in the circulating level of one or more components of the RAAS signaling pathway and / or the level of activity of one or more circulating components of the RAAS signaling pathway is maintained for at least 24 weeks, at least 6 months, at least 36 weeks, at least 9 months, at least 48 weeks, at least 12 months, or at least 52 weeks after administration.
[0204] In some embodiments, administering an AGT dsRNA agent described herein is effective to increase the circulating level of the RAAS signaling pathway component renin by 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95%, or more compared to baseline. In some embodiments, the level of activity of renin is increased by 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline. In some embodiments, a method described herein is effective to increase the circulating level of renin by 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline. In some embodiments, a method described herein is effective to increase the level of activity of renin by 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 85%, 90%, 95%, or more compared to baseline.
[0205] In some embodiments, one or more levels of angiotensinogen is measured. For example, in some embodiments, one or more levels of circulating angiotensinogen in human plasma are measured. For example, in some embodiments, a level of circulating angiotensinogen in human plasma is measured before administration and / or at one or more time points after administration of a dsRNA agent described herein. A level of angiotensinogen can be measured using ELISA technology, for example, a solid phase sandwich ELISA. A level of angiotensinogen can be measured using methods known in the art, including, for example, commercially available kits. Suitable kits for measuring a level of angiotensinogen include, for example, the Human Angiotensinogen (Total) ELISA kit from IBL America (Cat. No. 27412) , the Human Angiotensinogen (Intact) ELISA kit from IBL America (Cat. No. 27742) , Human Angiotensinogen ELISA Kit from Invitrogen (Cat. No. EH28RB) , Human Angiotensinogen ELISA Kit from Innovative Research (Cat. No. IHUAGTKT) , Human AGT / Angiotensinogen (Sandwich ELISA) ELISA Kit from LS Bio (Cat. No. LS-F26654) , Human Angiotensinogen ELISA Kit from Sion Biological (Cat. No. KIT10994) , and Human AGT ELISA kit from abcam (Cat. No. ab267592) .
[0206] In some embodiments, the present disclosure provides a method of reducing a level of one or more biomarkers in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to reduce one or more biomarker levels. In some embodiments, the level of one or more biomarkers that decreases is the level of renin, angiotensin 1, angiotensin 2, and / or aldosterone. In some embodiments, the level of one or more biomarkers in a subject is decreased relative to the level of the one or more biomarkers prior to administering the dsRNA agent. In some embodiments, the level of one or more biomarkers in a subject is the level of the biomarker in plasma, blood, or urine. In some embodiments, the present disclosure provides a method of increasing a level of one or more biomarkers in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to alter one or more biomarker levels.
[0207] In some embodiments, the present disclosure provides a method of reducing a level of activity of one or more biomarkers in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to reduce the level of activity of one or more biomarkers. In some embodiments, the level of activity of one or more biomarkers that decreases is the level of activity of renin. In some embodiments, the level of activity of one or more biomarkers in a subject is decreased relative to the level of activity of the one or more biomarkers prior to administering the dsRNA agent.
[0208] In some embodiments, the present disclosure provides a method of increasing a level of renin in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to increase the renin level. In some embodiments, the level of renin in a subject is increased relative to the level of renin prior to administering the dsRNA agent. In some embodiments, the present disclosure provides a method of increasing a level of renin in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to alter the level of renin.
[0209] In some embodiments, the present disclosure provides a method of increasing a level of activity of renin in a subject, comprising administering at least one of the dsRNA agents disclosed herein to the subject in an amount sufficient to increase the level of renin activity. In some embodiments, the level of activity of renin in a subject is increased relative to the level of activity of renin prior to administering the dsRNA agent.
[0210] In some embodiments, a method described herein is effective to achieve SBP <130 mmHg SBP in a subject, for example, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to reduce SBP in a subject by ≥10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to achieve SBP <130 mmHg SBP in a subject, for example, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) , and the method is effective to reduce SBP in the subject by ≥10 mmHg (e.g., from 10 mmHg to 20 mmHg) from baseline, as measured by ABPM at 3 months and / or 6 months after administering the AGT dsRNA agent (e.g., QCZ484) .
[0211] In some embodiments, a method described herein is effective to achieve SBP <130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to 130 mmHg) in a subject, for example, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to reduce SBP in a subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to achieve SBP<130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to <130 mmHg) in a subject, for example, as measured by ABPM at 3 months and / or 6 months after administering an AGT dsRNA agent (e.g., QCZ484) , and the method is effective to reduce SBP in the subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM at 3 months and / or 6 months after administering the AGT dsRNA agent (e.g., QCZ484) .
[0212] In some embodiments, a method described herein is effective to achieve SBP<130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to <130 mmHg) in a subject, for example, as measured by ABPM for at least 3 months, at least 4 months, at least 5 months, at least 24 weeks, at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 12 months, at least 48 weeks, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to reduce SBP in a subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM for at least 3 months, at least 4 months, at least 5 months, at least 24 weeks, at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 12 months, at least 48 weeks, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to achieve SBP <130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to <130 mmHg) in a subject, for example, as measured by ABPM for at least 3 months, at least 4 months, at least 5 months, at least 24 weeks, at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 48 weeks, at least 12 months, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administering an AGT dsRNA agent (e.g., QCZ484) , and the method is effective to reduce SBP in the subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM for at least 3 months, at least 4 months, at least 5 months, at least 24 weeks, at least 6 months, at least 7 months, at least 8 months, at least 9 months, at least 10 months, at least 11 months, at least 48 weeks, at least 12 months, at least 13 months, at least 14 months, at least 15 months, at least 16 months, at least 17 months, or at least 18 months after administering the AGT dsRNA agent (e.g., QCZ484) .
[0213] In some embodiments, a method described herein is effective to achieve SBP <130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to <130 mmHg) in a subject, for example, as measured by ABPM for 3-6 months, 3-12 months, 3-15 months, 3-18 months, 6-12 months, 6-15 months, 6-18 months, 12-15 months, or 12-18 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to reduce SBP in a subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM for 3-6 months, 3-12 months, 3-15 months, 3-18 months, 6-12 months, 6-15 months, 6-18 months, 12-15 months, or 12-18 months after administering an AGT dsRNA agent (e.g., QCZ484) . In some embodiments, a method described herein is effective to achieve SBP <130 mmHg (e.g., SBP <125 mmHg, <120 mmHg, <115 mmHg, <110 mmHg, <105 mmHg, <100 mmHg, <95 mmHg, about 90 mmHg, or from 90 mmHg to <130 mmHg) in a subject, for example, as measured by ABPM for 3-6 months, 3-12 months, 3-15 months, 3-18 months, 6-12 months, 6-15 months, 6-18 months, 12-15 months, or 12-18 months after administering an AGT dsRNA agent (e.g., QCZ484) and the method is effective to reduce SBP in the subject by ≥10 mmHg (e.g., by 10 mmHg, 15 mmHg, 20 mmHg, 25 mmHg, 30 mmHg, 35 mmHg, 40 mmHg, 45 mmHg, 50 mmHg, 55 mmHg, 60 mmHg, 65 mmHg, 70 mmHg, or from 10 mmHg to 70 mmHg) from baseline, as measured by ABPM for 3-6 months, 3-12 months, 3-15 months, 3-18 months, 6-12 months, 6-15 months, 6-18 months, 12-15 months, or 12-18 months after administering the AGT dsRNA agent (e.g., QCZ484) .
[0214] In some embodiments, the efficacy of treatment can be assessed by comparison to pre-dose levels and / or activity of AGT polypeptide in serum samples obtained from the subject (a” baseline” measurement) , or by comparison to non-exposure controls (e.g., the level / and or activity of AGT polypeptide in a control serum sample taken from a subject who is not given an AGT dsRNA agent or in a sample taken from a subject who does not have the disease) . The level of AGT polypeptide and / or the level of AGT polypeptide activity are related to the level of AGT gene expression, and thus can be used to measure the effects of the dsRNA agent on AGT gene expression.
[0215] In some embodiments, a method disclosed herein reduces serum AGT protein levels and / or activity levels, e.g., by at least 50%, at least 60%, at least 70%, at least 80%, or at least 90%, e.g., for at least 1-6 months, e.g., for at least one month, preferably for at least 6 months after administration of the dsRNA agent. In some embodiments, a method disclosed herein reduces serum AGT protein levels and / or activity levels, e.g., by at least 50%, at least 60%, at least 70%, at least 80%, or at least 90%, e.g., for at least 1-12 months, e.g., for at least one month, for at least 2 months, for at least 3 months, for at least 4 months, for at least 5 months, for at least 24 weeks, for at least 6 months, for at least 7 months, for at least 8 months, for at least 9 months, for at least 10 months, for at least 11 months, for at least 48 weeks, or for at least 12 months after administration of the dsRNA agent. In some embodiments, a method disclosed herein reduces serum AGT protein levels and / or activity levels, e.g., by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%, e.g., for at least 1-6 months, e.g., for at least one month, preferably for at least 6 months after administration of the dsRNA agent. In some embodiments, a method disclosed herein reduces serum AGT protein levels and / or activity levels, e.g., by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%, e.g., for at least 1-12 months, e.g., for at least one month, for at least 2 months, for at least 3 months, for at least 4 months, for at least 5 months, for at least 24 weeks, for at least 6 months, for at least 7 months, for at least 8 months, for at least 9 months, for at least 10 months, for at least 11 months, for at least 48 weeks, or for at least 12 months after administration of the dsRNA agent. In some embodiments, a method disclosed herein reduces serum AGT protein levels and / or activity levels by at least 50%for at least 48 weeks after administration of the dsRNA agent.
[0216] In some embodiments, when a subject is administered a dsRNA agent according to the methods disclosed herein, the level of the AGT polypeptide in a serum sample obtained from the subject is reduced by at least 60%, 65%, 70%, 75%, 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95%, or more as compared to a baseline level. In some embodiments, the level of the AGT polypeptide in a serum sample obtain from the subject is reduced by from 70%to 75%, from 70%to 80%, from 70%to 85%, from 70%to 90%, from 70%to 95%, from 70%to 99%, from 75%to 80%, from 75%to 85%, from 75%to 90%, from 75%to 95%, from 75%to 99%, from 80%to 85%, from 80%to 90%, from 80%to 95%, from 80%to 99%, 85%to 90%, from 85%to 95%, from 85%to 99%, from 90%to 95%, from 90%to 99%, or from 90%to 99%as compared to baseline. In some embodiments, the concentration of AGT polypeptide in serum can be measured by enzyme-linked immunosorbent assay (ELISA) . In some embodiments, administration reduces serum AGT levels by at least 70%. In some embodiments, administration reduces serum AGT levels by at least 75%. In some embodiments, administration reduces serum AGT levels by at least 80%. In some embodiments, administration reduces serum AGT levels by at least 85%. In some embodiments, administration reduces serum AGT levels by at least 90%. In some embodiments, administration reduces serum AGT levels by at least 95%. In some embodiments, administration reduces serum AGT levels by 80%-99%. In some embodiments, administration reduces serum AGT levels by 90%-99%. In some embodiments, administration reduces serum AGT levels by 90%-95%. In some embodiments, administration reduces serum AGT levels by 85%-95%. In some embodiments, administration reduces serum AGT levels by 85%-99%.
[0217] In certain embodiments, the method of treatment can further comprise modifying a treatment regimen based at least in part on an assessment of a change in one or more physiological characteristics of an AGT-associated disease or condition in the subject. In some embodiments, the one or more physiological characteristics of an AGT-associated disease or condition may comprise blood pressure (e.g., SBP or DBP) , cardiac output, peripheral resistance, renin production, and / or aldosterone secretion.
[0218] For example, in some embodiments, the effect of a dsRNA agent can be determined and used to help modulate the amount of dsRNA agent subsequently administered to the subject. In one non-limiting example, a dsRNA agent is administered to a subject, the subject’s blood pressure and / or AGT level or activity level is determined after administration, and based at least in part on the determined levels, treatment is continued, e.g., at the same or a higher amount of dsRNA agent to enhance the physiological effect of the administered agent, such as lowering or further lowering the blood pressure of the subject. In another non-limiting example, a dsRNA agent is administered to a subject, the subject’s blood pressure and / or AGT level or activity level is determined before and after administration, and based at least in part on the determined levels, a lower amount of dsRNA agent is administered.
[0219] In some embodiments, the AGT peptide level and / or activity level can be determined and compared to a control. The control can be a predetermined value, which can take many forms. It can be a single cutoff value, such as the median or mean. It can be established based on comparing groups, for example in a group with normal levels of AGT polypeptide and / or AGT polypeptide activity and in a group with increased levels of AGT polypeptide and / or AGT polypeptide activity. Another non-limiting example of a comparison group may be a population with one or more symptoms or diagnosis of an AGT-associated disease or condition versus a population without one or more symptoms or diagnosis of the disease or condition, or a group of subjects to which an AGT dsRNA was administered versus a group of subjects to which the treatment was not administered. In some embodiments, controls can be based on apparently healthy normal individuals or apparently healthy cells in an appropriate age group. In addition to predetermined values, a control may be a sample of material tested in parallel with the experimental material. Examples include samples from control populations or control samples produced by manufacturing for testing in parallel with experimental samples. In some embodiments, controls may include cells or subjects that have not been exposed to or treated with an AGT dsRNA agent, in which case the control levels of AGT polypeptides and / or AGT polypeptide activity may be compared to levels of AGT polypeptide and / or AGT polypeptide activity in a cell or subject exposed to an AGT dsRNA agent.
[0220] In some embodiments, a dsRNA agent is administered as a standalone therapy. In some embodiments, a dsRNA agent is administered in conjunction with one or more additional therapeutic agents to treat a cardiovascular disease. In some embodiments, the one or more additional therapeutic agents comprises a diuretic, a renin-angiotensin-aldosterone system (RAAS) inhibitor (such as an angiotensin converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) , a vascular Tensin II receptor antagonist, a beta-blocker, a vasodilator, a calcium channel blocker, an aldosterone antagonist, an alpha2-agonist, a renin inhibitor, an alpha-blocker, a peripherally acting adrenergic agent, a selective D1 receptor partial agonist, a non-selective alpha-adrenergic antagonist, a steroidal antimineralocorticoid, a hypertension agent, a low-density lipoprotein (LDL) -targeting agent, an RNAi agent other than the dsRNA agent, or a combination thereof.
[0221] In some embodiments, a subject being administered a dsRNA agent has not previously received a therapeutic agent for the treatment of a cardiovascular disease. In some embodiments, a subject being administered a dsRNA agent has previously received one or more therapeutic agents for the treatment of a cardiovascular disease. In some embodiments, a subject who has received one or more therapeutic agents for the treatment of a cardiovascular disease may stop using the one or more therapeutic agents before, e.g., 1, 2, 3, 4, 5 or more weeks before, e.g., for at least 4 weeks before beginning treatment with a dsRNA agent. In some embodiments, a subject being administered a dsRNA agent may also use a rescue therapeutic agent for the treatment of a cardiovascular event. Non-liming examples of a rescue therapeutic agent include, but are not limited to, nitroglycerin, clevidipine, nitroprusside, or a vasopressor (for example, norepinephrine, epinephrine, phenylephrine, vasopressin, or Angiotensin II) . In some embodiments, a subject being administered a dsRNA agent may also use a rescue treatment for the treatment of a cardiovascular event. Non-liming examples of a rescue treatment include, but are not limited to, conventional clinical measures including fluid and / or salt loading.
[0222] In some embodiments, a subject is treated with a dsRNA agent if the subject does not have evidence of hepatic disease. In some embodiments, evidence of hepatic disease comprises AST or ALT values > 2x ULN, total bilirubin > 1.5 mg / dL (subjects with Gilbert’s syndrome are allowed if TBL <2x ULN) , and / or international normalized ratio (INR) > 2x ULN (subjects on anticoagulant concomitant therapeutics with INR <3.5 may still be treated) . In some embodiments, a subject is treated with a dsRNA agent if they have not had a change in dose or regimen of a sodium-glucose co-transporter 2 (SGLT2) inhibitor before, e.g., within 30 days of beginning treatment with a dsRNA agent. In some embodiments, a subject is treated with a dsRNA agent if they do not have a current or history of intolerance to ACE inhibitors or ARBs. In some embodiments, a subject is treated with a dsRNA agent if they have not had a clinically significant cardiac arrhythmia (e.g., ventricular tachycardia) or high-grade AV (atrioventricular) block (e.g., Mobitz type II and third-degree AV block in absence of a pacemaker) before, e.g., within 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10 months, e.g., within 6 months, of beginning treatment with a dsRNA agent. In some embodiments, a subject is treated with a dsRNA agent if they do not have permanent or persistent atrial fibrillation. In some embodiments, a subject is treated with a dsRNA agent if they have not had clinically significant valvular heart disease. In some embodiments, a subject is treated with a dsRNA agent if they have not had one or more of an acute myocardial infraction, unstable angina, a percutaneous coronary intervention, and / or a coronary artery bypass graft before, e.g., within 12 months before, beginning treatment with a dsRNA agent. In some embodiments, a subject is treated with a dsRNA agent if they have not had one or more of human immunodeficiency virus (HIV) , a known or current chronic hepatitis C virus infection, and / or known or a current hepatitis B virus infection. In some embodiments, a subject is treated with a dsRNA agent if they do not have a history of or planned future liver or kidney transplantation. In some embodiments, a subject is treated with a dsRNA agent if they do not have a history of a renal denervation procedure. In some embodiments, a subject is treated with a dsRNA agent if they do not have a history of hospitalization for hypertensive emergencies, e.g., those characterized by severe hypertension (usually grade 3) associated with funduscopic changes (flame haemorrhages and / or papilloedema) , microangiopathy, disseminated intravascular coagulation, encephalopathy, acute aortic dissection, acute myocardial ischaemia, acute heart failure, and / or hospitalization for non-emergent / non-urgent uncontrolled hypertension without target organ damage before, e.g., within 12 months of beginning administration of the dsRNA agent. In some embodiments, a subject is treated with a dsRNA agent if they do not have a history of malignancy of any organ system (other than localized basal or squamous cell carcinoma of the skin or localized prostate cancer) , treated or untreated, before, e.g., within the past 3 years before beginning administration of the dsRNA agent. In some embodiments, a subject is treated with a dsRNA agent if they do not have a history of hypersensitivity to one or multiple drugs or allergic reaction to oligonucleotides or GalNAc. In some embodiments, a subject is treated with a dsRNA agent if they are not pregnant, nursing, or planning to become pregnant.
[0223] In various embodiments, disclosed herein are methods comprising administering a dsRNA agent described herein to a subject (e.g., a method of reducing serum AGT in a subject in need thereof, a method of treating hypertension in a subject in need thereof, a method of treating a cardiovascular disease in a subject in need thereof) , e.g., according to the dosing regimens disclosed herein. Also described herein are dosing regimens of a dsRNA agent described herein, or a composition thereof (e.g., a dosing regimen effective to reduce serum AGT in a subject, a dosing regimen effective to treat hypertension in a subject, a dosing regimen effective to treat a cardiovascular disease in a subject) . Also described herein are compositions, e.g., pharmaceutical compositions, for use of a dsRNA agent described herein (e.g., a composition comprising a dsRNA for use in reducing serum AGT in a subject, a composition comprising a dsRNA agent for use in treating hypertension in a subject, a composition comprising a dsRNA for use in treating a cardiovascular disease in a subject) . In various embodiments, the subject is a human subject. In some embodiments, the subject is male or female, aged 18 to 75 years old. In some embodiments, the subject has a body mass index (BMI) 18-35 kg / m2. In some embodiments, the subject has a body weight > 50 kg. In some embodiments, the subject has been diagnosed with hypertension. In some embodiments, the subject is hypertension treatment In some embodiments, the subject is on a maximum of 2 anti-hypertension medications and can undergo a washout of the medications for 4 weeks. In some embodiments, the subject has a mean sitting SBP of ≥ 130 and <160 mmHg. In some embodiments, the subject has a mean sitting SBP ≥140 mmHg measured by OBPM and a mean 24 hour SBP ≥130 mmHg and <160 mmHg measured by ABPM. In some embodiments, the subject does not have a clinically significant finding on a triplicate 12-lead electrocardiogram (ECG) after >5 minutes resting. In some embodiments, the subject does not have a history of hypotension or orthostatic hypotension. In some embodiments, the subject does not have a history of syncope within 1 year prior to administration of the dsRNA agent. In some embodiments, the subject does not have a known history of secondary hypertension (e.g., renovascular hypertension, primary aldosteronism, renal-parenchymal disease, pheochromocytoma, Cushing syndrome, aortic coarctation) . In some embodiments, the subject does not have secondary hypertension due to a history of moderate-to-severe obstructive sleep apnea not treated with continuous positive airway pressure therapy (e.g., face mask or nasal device) . In some embodiments, the subject does not have orthostatic hypotension prior to administration of the dsRNA agent, wherein orthostatic hypotension comprises a decrease of SBMP by ≥20 mmHg or DBP by ≥10 mmHg within approximately 1 to 3 minutes of standing up from seated position as measured by OBPM. In some embodiments, the subject does not have a serum potassium > 5 mEq / L (or equivalent plasma potassium value) prior to administration of the dsRNA agent. In some embodiments, the subject does not have a serum potassium > 5 mEq / L (or equivalent plasma potassium value) after 4 weeks of washout from anti-hypertension medication. In some embodiments, the subject does not have an eGFR ≤30 mL / min / 1.73m2 using CKD-Epi equation prior to administration of the dsRNA agent. In some embodiments, the subject does not have an eGFR ≤30 mL / min / 1.73m2 using CKD-Epi equation after 4 weeks of washout from anti-hypertension medication. In some embodiments, the subject does not have a calculated creatinine clearance ≤ 60 mL / min as calculated by the Cockcroft-Gault equation. In some embodiments, the subject does not have any evidence of hepatic disease. In some embodiments, the subject does not have aspartate transaminase (AST) or alanine transaminase (ALT) values > 2 x ULN (upper limit of normal) prior to administration of the dsRNA agent. In some embodiments a subject does not have an AST or ALT values > 1.2 x ULN. In some embodiments, the subject does not have alkaline phosphatase (ALP) value > 1.2 x ULN. In some embodiments, the subject does not have a gamma-glutamyl transferase (GGT) value > 1.2 x ULN. In some embodiments, the subject does not have a total bilirubin > 1.5 mg / dL prior to administration of the dsRNA agent. In some embodiments, a subject has Gilbert’s syndrome and a total bilirubin < 2 x ULN prior to administration of the dsRNA agent. In some embodiments, the subject does not have an international normalized ratio (INR) > 2.0 prior to administration of the dsRNA agent. In some embodiments, the subject is receiving an anticoagulant medication and has an INR < 3.5 prior administration of the dsRNA agent. In some embodiments, the subject does not have a creatine phosphokinase > 1.5 x ULN prior to administration of the dsRNA agent. In some embodiments, the subject has, is suffering from, or is at risk of developing a cardiovascular disease (e.g., hypertension) .
[0224] In some embodiments, the subject has not received an investigational agent within last 30 days or 5 half-lives, whichever is longer, prior to administration of the dsRNA agent. In some embodiments, the subject has not used prescription drugs, excluding oral contraceptive pills and sex hormone replacement therapy, within 14 days or 5 half-lives (whichever is longer) prior to administration of the dsRNA agent. In some embodiments, the subject has not used prescription drugs within 14 days or 5 half-lives (whichever is longer) prior to administration of the dsRNA agent except for medications to treat dyslipidemia, diabetes, migraine, or asthma; hormone replacement therapy; contraceptive therapy; selective serotonin reuptake inhibitor; proton pump inhibitors; histamine H2-receptor antagonists; and topical, intra-articular, nasal, inhaled, and ophthalmic steroid therapies if the subject is in a controlled condition on the stable therapy. In some embodiments, the subject is not in the follow-up of a clinical trial prior to administration of the dsRNA agent. In some embodiments, the subject has not used more than 10 tobacco / nicotine containing products or equivalents per day within 30 days prior to administration of the dsRNA agent.
[0225] In some embodiments, the subject does not have a medical condition, other than hypertension, requiring treatment with an RAAS inhibitor. In some embodiments, the subject does not have any history of congestive heart failure as defined by any one of classes II-IV from the New York Heart Associated, wherein class II consists of symptoms of heart failure with moderate exertion (e.g., ambulating two blocks or two flights of stairs) , class III consists of symptoms of heart failure with minimal exertion (e.g., ambulating one block or one flight of stairs) without experiencing symptoms at rest, and class IV consists of symptoms of heart failure at rest. In some embodiments, the subject is not receiving beta-blockers that can not be discontinued while receiving the dsRNA agent. In some embodiments, the subject does not have an unstable treatment with a sodium-glucose co-transporter 2 (SGLT2) inhibitor, wherein unstable treatment is defined as any changes in dose or regimen within 30 days prior to administration of the dsRNA agent. In some embodiments, the subject is not and will not receive a non-steroidal anti-inflammatory drugs (NSAIDs) excluding aspirin, organic nitrate preparations (nitroglycerin, isosorbide mononitrate, isosorbide dinitrate, pentaerythritol) , medications or herbal supplements that are associated with increased liver function tests abnormalities and / or hyperkalemia, moderate to high doses of glucocorticosteroids, alpha blockers, or sympathomimetic drugs (e.g., pseudoephedrine, phenylephrine, and other ephedrine derivatives often found in oral / nasal decongestants, diet aids, attention deficit hyperactivity disorder drugs) while receiving the dsRNA agent. In some embodiments, the subject does not use and will not use an siRNA other than the dsRNA agent disclosed herein. In some embodiments, the subject does not experience or has not experienced intolerance to an angiotensin-converting enzyme inhibitors (ACEi) and / or angiotensin receptor blocker (ARB) .
[0226] In some embodiments, the subject does not have Type 1 diabetes mellites (T1 DM) , uncontrolled T2DM (HbA1c >9%) or newly diagnosed diabetes prior to administration of the dsRNA agent. In some embodiments, the subject does not have any clinically significant cardiac arrhythmias (e.g., ventricular tachycardia) , high-grade AV block (e.g., Mobitz type II and third-degree AV block in absence of a pacemaker) within 6 months prior to administration of the dsRNA agent. In some embodiments, the subject does not have permanent or persistent atrial fibrillation. In some embodiments, the subject does not have a clinically significant valvular heart disease. In some embodiments, the subject does not have acute myocardial infarction (AMI) , unstable angina, any percutaneous coronary intervention (PCI) , or coronary artery bypass graft (CABG) within 12 months prior to administration of the dsRNA agent. In some embodiments, the subject does not have an unstable or underlying known cardiovascular disease, wherein cardiovascular disease comprises any history of congestive heart failure, any history of previous myocardial infraction, coronary revascularization, unstable or stable angina pectoris within 6 months prior to administration of the dsRNA agent, any hemodynamically unstable atrial or ventricular arrhythmias, significant uncorrected valvular heart disease, any history of stroke or transient ischemic attack within 6 months prior to administration of the dsRNA agent, and peripheral vascular disease. In some embodiments, the subject does not have human immunodeficiency virus (HIV) , known current or chronic hepatitis C virus (HCV) , or hepatitis B virus (HBV) infection. In some embodiments, the subject does not have a history of or planned liver or kidney transplantation while receiving the dsRNA agent. In some embodiments, the subject has not had a cardiac valve repair, cardiac device implantation, and / or hospitalization for heart failure within 3 months of administration of the dsRNA agent. In some embodiments, the subject is not using an immunosuppressive treatment while receiving the dsRNA agent. In some embodiments, the subject does not have a history of a renal denervation procedure. In some embodiments, the subject does not have a mid-arm circumference ≥ 44 cm. In some embodiments, the subject does not have any history of hospitalization for a hypertensive emergency characterized by severe hypertension (usually grade 3) associated with funduscopic changes (e.g., flame haemorrhages and / or papilloedema) , microangiopathy, disseminated intravascular coagulation, encephalopathy, acute aortic dissection, acute myocardial ischaemia, acute heart failure any time prior to administration of the dsRNA agent. In some embodiments, the subject has not been hospitalized for non-emergent / non-urgent uncontrolled hypertension without target organ damage within 12 months prior to administration of the dsRNA agent. In some embodiments, the subject has not been hospitalized for any reason within 60 days prior to administration of the dsRNA agent. In some embodiments, the subject is not a night shift worker. In some embodiments, the subject does not have the history of presence of any other disease that in the opinion of a medical professional would jeopardize the safety of the subject. In some embodiments, the subject does not have a history of malignancy of any organ system (other than localized basal or squamous cell carcinoma of the skin or localized prostate cancer) within 3 years prior to administration of the dsRNA agent. In some embodiments, the subject does not have a history of drug abuse or alcohol dependency.
[0227] In some embodiments, the subject has not used marijuana within 30 days prior to administration of the dsRNA agent. In some embodiments, the subject has not received a live vaccine (except for the influenza vaccine) within 4 weeks prior to administration of the dsRNA agent or will not receive a live vaccine while receiving the dsRNA agent. In some embodiments, the subject does not have a history of hypersensitivity to multiple drugs. In some embodiments, the subject has not had an allergic reaction to an oligonucleotide or GalNAc. In some embodiments, the subject has not had a clinically significant illness within 7 days prior to administration of the dsRNA agent. In some embodiments, the subject is not pregnant, nursing, or planning to become pregnant. In some embodiments, the subject is a woman of child-bearing potential and is using a method of contraception with a failure rate of <1%per year. In some embodiments, the subject has not donated or lost > 200 mL of blood in the 2 months prior to administration of the dsRNA agent. E. Administration Methods
[0228] Various routes of administration of AGT dsRNA agents or AGT antisense polynucleotide agents can be used. The selection of a particular delivery mode will depend, at least in part, on the specific condition being treated and the dose required for therapeutic efficacy. In general, any mode of administration that is medically acceptable may be used.
[0229] In some embodiments, an intravenous route is used. In some embodiments, a subcutaneous route is used. In some embodiments, an AGT dsRNA agent may be administered via an oral, enteral, mucosal, subcutaneous, and / or parenteral route. The term “parenteral” includes subcutaneous, intravenous, intrathecal, intramuscular, intraperitoneal, and intrasternal injection or infusion techniques. Other routes include, but are not limited to, nasal (e.g., via a gastronasal tube) , transdermal, vaginal, rectal, sublingual, and inhalation. Delivery routes may include intrathecal, intraventricular, or intracranial. In some embodiments, an AGT dsRNA agent can be placed in a slow release matrix and administered by placing the matrix in a subject. In some embodiments, AGT dsRNA agents may be delivered to cells of a subject using nanoparticles coated with a delivery agent that targets specific cells or organelles.
[0230] In some embodiments, an AGT dsRNA agent is in a composition. The compositions may comprise one or more AGT dsRNA agents and optionally one or more pharmaceutically acceptable carriers, delivery agents, detectable labels, etc. “Pharmaceutically acceptable” means that the carrier is compatible with the active ingredient of the composition (and preferably, capable of stabilizing the active ingredient) and not deleterious to the subject to be treated. Examples of pharmaceutically acceptable carriers (excipients) , including buffers, would be apparent to the skilled artisan and have been described previously. See, e.g., Remington: The Science and Practice of Pharmacy 20th Ed. (2000) Lippincott Williams and Wilkins, Ed. K. E. Hoover. Acceptable carriers, excipients, or stabilizers are nontoxic to recipients at the doses and concentrations used, and may comprise buffers such as phosphate, citrate, and other organic acids; antioxidants including ascorbic acid and methionine; preservatives (such as octadecyldimethylbenzyl ammonium chloride; hexamethonium chloride; benzalkonium chloride, benzethonium chloride; phenol, butyl or benzyl alcohol; alkyl parabens such as methyl or propyl paraben; catechol; resorcinol; cyclohexanol; 3-pentanol; and m-cresol) ; low molecular weight (less than about 10 residues) polypeptides; proteins, such as serum albumin, gelatin, or immunoglobulins; hydrophilic polymers such as polyvinylpyrrolidone; amino acids such as glycine, glutamine, asparagine, histidine, arginine, or lysine; monosaccharides, disaccharides, and other carbohydrates including glucose, mannose, or dextrans; chelating agents such as EDTA; sugars such as sucrose, mannitol, trehalose or sorbitol; salt-forming counter-ions such as sodium; metal complexes (e.g. Zn-protein complexes) ; and / or non-ionic surfactants such as TWEENTM, PLURONICSTM or polyethylene glycol (PEG) .
[0231] Where the AGT dsRNA agents of the present disclosure are administered together with and / or linked to one or more delivery agents, labeling agents, etc., one skilled in the art would understand and be able to select and use appropriate carriers, including buffering agents, stabilizers and the like. Labeling agents may be used in certain embodiments to determine the location of an AGT dsRNA agent in cells and tissues, and may be used to identify a cell, tissue, or organ location of a therapeutic composition comprising an AGT dsRNA agent administered in the methods disclosed herein. Means for attaching and using labeling reagents such as enzyme labels, dyes, radiolabels, etc. are known in the art. In some embodiments, a labeling agent is linked to one or both of a sense and an antisense strand of an AGT dsRNA agent.
[0232] In some embodiments, one or more AGT dsRNA agents may be administered in the form of a pharmaceutical composition, which may contain pharmaceutically acceptable concentrations of salts, buffers, preservatives, compatible carriers, and / or adjuvants. In some embodiments, the preparation may comprise other therapeutic ingredients, e.g., for treating a cardiovascular disease. As used herein, a pharmaceutically acceptable carrier refers to a nontoxic material that does not interfere with the effectiveness of the biological activity of the active ingredient.
[0233] Formulations for parenteral administration may include sterile aqueous or non-aqueous solutions, suspensions and emulsions. Examples of non-aqueous solvents are propylene glycol, polyethylene glycol, vegetable oils such as olive oil, and injectable organic esters such as ethyl oleate. Aqueous carriers include water, alcoholic / aqueous solutions, emulsions or suspensions, including saline and buffered media. Parenteral carriers include sodium chloride solution, Ringe...
Claims
1.A method for reducing serum angiotensin (AGT) levels for at least 6 months in a subject, the method comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 2, andwherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels.2.A method for treating a cardiovascular disease in a subject in need thereof, comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 2, andwherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels, thereby treating the subject’s cardiovascular disease.3.The method of claim 2, wherein the cardiovascular disease is an atherosclerotic cardiovascular disease (ASCVD) .4.The method of claim 3, wherein the ASCVD is one or more of coronary heart disease (CHD) , myocardial infarction, angina, coronary artery stenosis, a cerebrovascular disease, a transient ischemic attack, ischemic stroke, hemorrhagic stroke, heart failure, kidney failure, carotid artery stenosis, a peripheral artery disease, claudication, an aortic atherosclerotic disease, abdominal aortic aneurysm, and descending thoracic aneurysm.5.The method of claim 2, wherein the cardiovascular disease is a non-atherosclerotic cardiovascular disease.6.The method of claim 5, wherein the non-atherosclerotic cardiovascular disease is one or more of spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging and stress-induced cardiomyopathy (Takotsubo syndrome) , non-atherosclerotic peripheral artery disease, fibromuscular dysplasia (FMD) , spontaneous coronary artery dissection (SCAD) , a congenital coronary artery anomaly, coronary aneurysm, coronary arteritis, coronary artery dissection, coronary artery thrombosis without underlying atherosclerotic plaque (thrombosis in situ) , a coronary embola, a coronary fistula, a coronary ostia, a fixed luminal obstruction, aneurysm, aortic dissection, embolus, occlusive fibroelastois, supravalvular aortic stenosis with severe intimal thickening, syphilis, Takayasu disease, intimal fibrous proliferation, myocardial oxygen demand supply disproportion, a systemic metabolic disorder, Fabry disease, homocystinuria, Hunter and Hurler diseases, primary oxalosis, Sandhoff disease, and intramural coronary artery disease.7.The method of any one of claims 1-6, wherein the dsRNA is administered parenterally, preferably subcutaneously.8.The method of any one of claims 1-7, wherein the antisense strand and / or the sense strand further comprise at least one modified nucleotide.9.The method of claim 8, wherein the at least one modified nucleotide comprises 2’ -Fluoronucleotides, 2’-O-methyl nucleotides, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof.10.The method of any one of claims 1-9, wherein each of the sense and antisense strands comprises 1, 2, 3, or 4 phosphorothioate linkages.11.The method of any one of claims 1-10, wherein each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue.12.The method of any one of claims 1-11, wherein an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is 13.The method of any one of claims 8-12, wherein the sense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 3 and comprises the modifications of SEQ ID NO: 3, and the antisense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 4 and comprises the modifications of SEQ ID NO: 4.14.The method of any one of claims 1-13, wherein administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, or 95%compared to a baseline serum AGT level.15.The method of any one of claims 1-14, wherein the reduction in serum AGT level is achieved by 29 days after administration.16.The method of any one of claims 1-15, wherein the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration.17.The method of any one of claims 1-16, wherein the serum AGT level is reduced by at least 80%at 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration.18.The method of any one of claims 1-17, wherein administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 90%by 29 days after administration, and the serum AGT level is less than 50%compared to a baseline serum AGT level at 48 weeks after administration.19.The method of any one of claims 1-18, wherein the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) .20.The method of claim 19, wherein the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg.21.The method of any one of claims 1-20, wherein the dsRNA agent is administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.22.The method of any one of claims 1-21, wherein administration of the dsRNA agent achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration.23.The method of any one of claims 1-22, wherein the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .24.The method of any one of claims 1-23, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2.25.The method of any one of claims 1-24, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , and wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 is 26.The method of any one of claims 1-25, wherein the dsRNA agent is administered in conjunction with one or more additional therapeutic agents.27.The method of claim 26, wherein the one or more additional therapeutic agents comprises a diuretic, an angiotensin converting enzyme (ACE) inhibitor, a vascular Tensin II receptor antagonist, a beta-blocker, a vasodilator, a calcium channel blocker, an aldosterone antagonist, an alpha2-agonist, a renin inhibitor, an alpha-blocker, a peripherally acting adrenergic agent, a selective D1 receptor partial agonist, a non-selective alpha-adrenergic antagonist, a steroidal antimineralocorticoid, a hypertension agent, a low-density lipoprotein (LDL) -targeting agent, an RNAi agent other than the dsRNA agent, or a combination thereof.28.A method of treating hypertension for at least 6 months in a subject in need thereof, the method comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to SEQ ID NO: 2,wherein administering the dsRNA is effective to reduce the subject’s systolic blood pressure (SBP) by at least 10 mmHg compared to the subject’s baseline SBP level, andwherein administering the dsRNA is effective to reduce the subject’s diastolic blood pressure (DBP) by at least 5 mmHg compared to the subject’s baseline DBP level, thereby treating the hypertension.29.The method of claim 28, wherein the dsRNA is administered parenterally, preferably subcutaneously.30.The method of claim 28 or 29, wherein the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide.31.The method of claim 30, wherein the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’-O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof.32.The method of any one of claims 28-31, wherein each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages.33.The method of any one of claims 28-32, wherein each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue.34.The method of any one of claims 28-33, wherein an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is 35.The method of any one of claims 28-34, wherein the sense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 3 and comprises the modifications of SEQ ID NO: 3, and the antisense strand comprises a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 4 and comprises the modifications of SEQ ID NO: 4.36.The method of any one of claims 28-35, wherein the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) .37.The method of claim 36, wherein the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg.38.The method of any one of claims 28-37, wherein the dsRNA agent is administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.39.The method of any one of claims 28-38, wherein administration of the dsRNA agent achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration.40.The method of any one of claims 28-39, wherein the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .41.The method of any one of claims 28-40, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2.42.The method of any one of claims 28-41, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , and wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 is 43.The method of any one of claims 28-42, wherein the dsRNA agent is administered in conjunction with one or more additional therapeutic agents.44.The method of claim 43, wherein the one or more therapeutic agents comprises a diuretic, an angiotensin converting enzyme (ACE) inhibitor, a vascular Tensin II receptor antagonist, a beta-blocker, a vasodilator, a calcium channel blocker, an aldosterone antagonist, an alpha2-agonist, a renin inhibitor, an alpha-blocker, a peripherally acting adrenergic agent, a selective D1 receptor partial agonist, a non-selective alpha-adrenergic antagonist, a steroidal antimineralocorticoid, a hypertension agent, a low-density lipoprotein (LDL) -targeting agent, an RNAi agent other than the dsRNA agent, hypertension or a combination thereof.45.A method for reducing serum angiotensin (AGT) levels for at least 6 months in a subject, the method comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising a nucleotide sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 isandwherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels.46.A method for treating a cardiovascular disease in a subject in need thereof, the method comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising a nucleotide sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 isandwherein serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to baseline serum AGT levels, thereby treating the subject’s cardiovascular disease.47.A method of treating hypertension for at least 6 months in a subject in need thereof, the method comprising administering to the subject a double-stranded ribonucleic acid (dsRNA) agent at a dose of 50-800 mg,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising a nucleotide sequence of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , wherein wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 isandwherein administration the dsRNA is effective to reduce the subject’s systolic blood pressure (SBP) at least 10 mmHg compared to the subject’s baseline SBP level, andwherein administration the dsRNA is effective to reduce the subject’s diastolic blood pressure (DBP) at least 5 mmHg compared to the subject’s baseline DBP level,thereby treating the subject’s hypertension.48.The method of any one of claims 45-47, wherein the serum AGT level is reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration.49.The method of any one of claims 45-48, wherein the serum AGT level is reduced by at least 80%at 24 weeks, 6 months, 36 weeks, 9 months, 48 weeks, 12 months, or 52 weeks after administration.50.The method of any one of claims 45-49, wherein administration of the dsRNA agent is effective to reduce serum AGT level in the subject by at least 90%by 29 days after administration, and the serum AGT level is less than 50%compared to a baseline serum AGT level at 48 weeks after administration.51.The method of any one of claims 45-50, wherein the dsRNA agent is administered at a dose of 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) .52.The method of claim 51, wherein the dsRNA agent is administered at a dose of 150-300 mg, e.g., 150 mg.53.The method of any one of claims 1-52, wherein the dsRNA agent is a sodium salt form of the dsRNA agent.54.A composition comprising a dsRNA agent for use in reducing serum AGT levels,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2,wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, andwherein the serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to the baseline serum levels.55.A composition comprising a dsRNA agent for use in reducing systolic blood pressure,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2,wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, andwherein the blood pressure is reduced by at least 10 mmHg at least 3 months after administration of the dsRNA agent compared to the baseline systolic blood pressure levels.56.A composition comprising a dsRNA agent for use in reducing diastolic blood pressure,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2,wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, andwherein the blood pressure is reduced by at least 10 mmHg at least 3 months after administration of the dsRNA agent compared to the baseline diastolic blood pressure levels.57.The composition of any one of claims 54-56, wherein the composition is formulated for subcutaneous administration.58.The composition of any one of claims 54-57, wherein the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide.59.The composition of claim 58, wherein the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’ -O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof.60.The composition of any one of claims 54-59, wherein each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages.61.The composition of any one of claims 54-60, wherein each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue.62.The composition of any one of claims 54-61, wherein an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is 63.The composition of any one of claims 54-62, wherein the composition comprises a 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) dose of the dsRNA agent.64.The composition of any one of claims 54-63, wherein the composition comprises a 150-300 mg (e.g., 150 mg) dose of the dsRNA agent.65.The composition of any one of claims 54-64, wherein the composition administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.66.The composition of any one of claims 54-65, wherein administration of the composition achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration.67.The composition of any one of claims 54-66, wherein the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .68.The composition of any one of claims 54-67, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2.69.The composition of any one of claims 54-68, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , and wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 is 70.A composition comprising a dsRNA agent for use in treating a cardiovascular disease,wherein the dsRNA agent comprises a sense strand comprising a nucleotide sequence that is≥90%identical to the nucleotide sequence SEQ ID NO: 1 and an antisense strand comprising a nucleotide sequence that is ≥90%identical to the nucleotide sequence of SEQ ID NO: 2,wherein the composition is formulated to administer a dose of the dsRNA agent of 50-800 mg, andwherein the serum AGT levels are reduced by at least 80%at least 6 months after administration of the dsRNA agent compared to the baseline serum levels.71.The composition of claim 70, wherein the cardiovascular disease is an atherosclerotic cardiovascular disease (ASCVD) .72.The composition of claim 71, wherein the ASCVD is one or more of coronary heart disease (CHD) , myocardial infarction, angina, coronary artery stenosis, a cerebrovascular disease, a transient ischemic attack, ischemic stroke, hemorrhagic stroke, heart failure, kidney failure, carotid artery stenosis, a peripheral artery disease, claudication, an aortic atherosclerotic disease, abdominal aortic aneurysm, and descending thoracic aneurysm.73.The composition of claim 70, wherein the cardiovascular disease is a non-atherosclerotic cardiovascular disease.74.The composition of claim 73, wherein the non-atherosclerotic cardiovascular disease is one or more of spontaneous coronary artery dissection, coronary artery embolism, vasospasm, myocardial bridging and stress-induced cardiomyopathy (Takotsubo syndrome) , non-atherosclerotic peripheral artery disease, fibromuscular dysplasia (FMD) , spontaneous coronary artery dissection (SCAD) , a congenital coronary artery anomaly, coronary aneurysm, coronary arteritis, coronary artery dissection, coronary artery thrombosis without underlying atherosclerotic plaque (thrombosis in situ) , a coronary embola, a coronary fistula, a coronary ostia, a fixed luminal obstruction, aneurysm, aortic dissection, embolus, occlusive fibroelastois, supravalvular aortic stenosis with severe intimal thickening, syphilis, Takayasu disease, intimal fibrous proliferation, myocardial oxygen demand supply disproportion, a systemic metabolic disorder, Fabry disease, homocystinuria, Hunter and Hurler diseases, primary oxalosis, Sandhoff disease, and intramural coronary artery disease.75.The composition of any one of claims 70-74, wherein the composition is formulated for subcutaneous administration.76.The composition of any one of claims 70-75, wherein the antisense strand sequence and / or the sense strand sequence further comprise at least one modified nucleotide.77.The composition of claim 76, wherein the at least one modified nucleotide comprises 2’ -Fluoronucleotide, 2’ -O-methyl nucleotide, or a combination thereof, preferably where all the nucleotides in the sense and / or antisense strand comprise 2’ -Fluoronucleotides, 2’ -O-methyl nucleotides, or combinations thereof.78.The composition of any one of claims 70-77, wherein each of the sense strand and the antisense strand comprises 1, 2, 3, or 4 phosphorothioate linkages.79.The composition of any one of claims 70-78, wherein each of the 5’ -end and the 3’ -end of the sense strand is conjugated to an inverted abasic residue.80.The composition of any one of claims 70-79, wherein an end of the sense strand, preferably the 5’ -end of the sense strand, is conjugated to a targeting group comprising a N-acetyl-galactosamine (GalNAc) , preferably wherein the targeting group is 81.The composition of any one of claims 70-80, where the serum AGT levels are reduced by at least 50%at 48 weeks, 12 months, or 52 weeks after administration.82.The composition of any one of claims 70-81, wherein the composition comprises a 50-600 mg (e.g., 50-300 mg, 300-600 mg, 150-300 mg, 50-150 mg) dose of the dsRNA agent.83.The composition of any one of claims 70-82, wherein the composition comprises a 150-300 mg (e.g., 150 mg) dose of the dsRNA agent.84.The composition of any one of claims 70-83, wherein the composition administered once every 6 months, once every 7 months, once every 8 months, once every 9 months, once every 10 months, once every 11 months, or once every 12 months, optionally as a standalone therapy.85.The composition of any one of claims 70-84, wherein administration of the composition achieves a plasma concentration of at least 100 ng / mL of the dsRNA agent 8 hours after administration.86.The composition of any one of claims 70-85, wherein the dsRNA agent has a serum half-life (T1 / 2) of about 3.5-6.5 hours (e.g., about 4.5-5.5 hours) .87.The composition of any one of claims 70-86, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence of SEQ ID NO: 1 and an antisense strand comprising the nucleic acid sequence of SEQ ID NO: 2.88.The composition of any one of claims 70-87, wherein the dsRNA agent comprises a sense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 3 ( (GLS-15) * (Invab) *caccagcuUgUuUgugaaaca* (Invab) ) and an antisense strand comprising the nucleic acid sequence and modifications of SEQ ID NO: 4 (u*G*uuucAcaaaCaAgCugg*u*g) , and wherein each nucleotide in lowercase is a 2’ -OMe modification, each nucleotide in uppercase is a 2’ -fluoro modification, each star (*) indicates a phosphorothioate linkage, each Invab indicates an inverted abasic residue, and GLS-15 is 89.The composition of any one of claims 54-88, wherein the dsRNA agent is a sodium salt form of the dsRNA agent.