Ocedurenone (KBP-5074): A Comprehensive Report on its Development, Clinical Profile, and Discontinuation

I. Introduction to Ocedurenone

A. Overview of Ocedurenone (KBP-5074)

Ocedurenone, identified by the investigational name KBP-5074, is a novel, orally administered small molecule pharmaceutical agent.[1] It was engineered as a third-generation non-steroidal mineralocorticoid receptor antagonist (nsMRA).[3] This classification is significant, as it positions Ocedurenone in a therapeutic class aiming to improve upon older, steroidal MRAs, such as spironolactone and eplerenone, and to compete with other contemporary nsMRAs like finerenone. The development of third-generation nsMRAs generally seeks to optimize the balance of efficacy and safety, particularly concerning side effects common to earlier MRAs.

B. Initial Therapeutic Promise and Targeted Indications

Ocedurenone was primarily developed and investigated for the treatment of uncontrolled hypertension. A particular focus was placed on patients with advanced chronic kidney disease (CKD), specifically those with stage 3b or stage 4 CKD.[5] This patient demographic represents a substantial unmet medical need, as managing hypertension in the presence of advanced CKD is challenging due to the high risk of cardiovascular complications and the limitations of existing antihypertensive treatments, especially concerning the risk of hyperkalemia.[7]