Finerenone

Finerenone is an emerging drug being studied in clinical trials for its potential benefits in treating chronic kidney disease (CKD) and type 2 diabetes (T2D). This non-steroidal mineralocorticoid receptor antagonist has shown promise in slowing the progression of kidney disease and reducing cardiovascular risks in patients with these conditions. The ongoing trials aim to evaluate its efficacy, safety, and mechanisms of action across various patient populations.

Table of Contents

What is Finerenone?

Finerenone is a new medication that belongs to a class of drugs called mineralocorticoid receptor antagonists (MRAs). It is also known by the brand name Kerendia[2]. Finerenone is a non-steroidal MRA, which means it works differently from older medications in this class[3].

How Finerenone Works

Finerenone works by blocking a protein in the body called the mineralocorticoid receptor (MR). When this receptor is overactive, it can lead to problems like high blood pressure, organ damage, and worsening of heart failure. By blocking this receptor, Finerenone helps to reduce these harmful effects[5].

Conditions Treated by Finerenone

Finerenone is primarily used to treat two related conditions:

  • Chronic Kidney Disease (CKD): This is a long-term condition where the kidneys gradually lose their ability to function properly[1].
  • Type 2 Diabetes: This is a condition where the body doesn’t use insulin properly, leading to high blood sugar levels[9].

Finerenone is particularly useful for patients who have both CKD and Type 2 diabetes, as these conditions often occur together and can worsen each other[6].

Effectiveness of Finerenone

Clinical trials have shown that Finerenone can be effective in:

  • Slowing the progression of chronic kidney disease[1]
  • Reducing the risk of kidney failure[1]
  • Lowering the risk of cardiovascular events (such as heart attacks and strokes) in patients with CKD and Type 2 diabetes[1]
  • Reducing albuminuria, which is a sign of kidney damage[1]

Dosage and Administration

Finerenone is typically taken as a tablet once daily. The starting dose may vary depending on the patient’s kidney function:

  • For patients with moderately reduced kidney function, the starting dose is usually 10 mg once daily[10].
  • For patients with normal or mildly reduced kidney function, the starting dose may be 20 mg once daily[10].

The dose may be adjusted by your doctor based on your response to the medication and your blood test results[10].

Side Effects and Safety

Like all medications, Finerenone can cause side effects. The most common side effect is an increase in blood potassium levels (hyperkalemia). Other potential side effects include:

  • Decreased kidney function
  • Low blood pressure
  • Dizziness

It’s important to note that Finerenone appears to have fewer hormonal side effects (such as breast enlargement in men or menstrual irregularities) compared to older MRAs like spironolactone[8].

Ongoing Research

Researchers are currently conducting several studies to further understand the benefits and potential uses of Finerenone. Some areas of ongoing research include:

  • Its effectiveness in treating primary aldosteronism, a condition that causes high blood pressure[2][3]
  • Its effects on vascular stiffness (hardening of the arteries) in patients with Type 2 diabetes and CKD[9]
  • Long-term safety and effectiveness in real-world settings[6]

These ongoing studies will help doctors better understand how to use Finerenone effectively and safely in different patient groups.

Aspect Details
Drug Name Finerenone (also known as BAY94-8862 or Kerendia)
Drug Class Non-steroidal selective mineralocorticoid receptor antagonist (MRA)
Primary Conditions Studied Chronic Kidney Disease (CKD) with Type 2 Diabetes (T2D)
Other Conditions Primary Aldosteronism, Worsening Chronic Heart Failure
Main Outcomes Measured Changes in UACR, eGFR, blood pressure, cardiovascular events, kidney disease progression
Dosage 10-20 mg oral tablets, once daily (adjusted based on kidney function)
Key Safety Monitoring Serum potassium levels, blood pressure, overall tolerability
Potential Benefits Slowing CKD progression, reducing cardiovascular risks, improving vascular health
Ongoing Research Focus Efficacy in various patient populations, long-term safety, mechanisms of action

Ongoing Clinical Trials on Finerenone

  • A Study Testing Drug Combination for Heart Failure in Women Comparing Increased Doses to Standard Care

    Recruiting

    3 1 1 1
    Italy
  • A study of finerenone added to standard treatment in children aged 6 months to under 18 years with heart failure and reduced left heart pumping function

    Recruiting

    3 1
    Investigated drugs:
    Austria Belgium Bulgaria Czechia Finland Germany +7
  • A study of finerenone with standard treatment for children and young adults from birth to 18 years with heart failure and left ventricular systolic dysfunction

    Recruiting

    3 1 1
    Investigated drugs:
    Austria Belgium Bulgaria Czechia Finland Germany +7
  • A study testing finerenone compared to placebo in patients with chronic kidney disease who are not taking renin-angiotensin-system inhibitors

    Recruiting

    3 1
    Investigated diseases:
    Investigated drugs:
    Spain
  • Study of semaglutide and finerenone for kidney and blood vessel protection in adults with chronic kidney disease, with or without diabetes

    Recruiting

    3 1 1 1
    Investigated diseases:
    Investigated drugs:
    Denmark
  • Study on the Effects and Safety of Finerenone for Patients with Heart Failure Who Cannot Use Steroidal Mineralocorticoid Receptor Antagonists

    Recruiting

    3 1
    Investigated drugs:
    Croatia Czechia Greece Hungary Italy Poland +1
  • Study to Find Treatments for Chronic Kidney Disease Using Finerenone in Patients with Standard Care

    Recruiting

    3 1 1
    Investigated diseases:
    Investigated drugs:
    Greece Spain
  • Study on Dapagliflozin, Finerenone, and Semaglutide for Treating Chronic Kidney Disease in Patients

    Recruiting

    3 1 1 1
    Investigated diseases:
    Denmark Germany Italy Spain Sweden
  • Study on Using Dapagliflozin, Semaglutide, and Finerenone to Prevent Heart and Kidney Complications in Patients with Type 2 Diabetes

    Recruiting

    3 1 1 1
    Investigated diseases:
    Denmark Spain
  • Study on the Effectiveness and Safety of Finerenone and Empagliflozin in Patients Hospitalized with Heart Failure

    Recruiting

    3 1 1 1
    Investigated drugs:
    Spain

Glossary

  • Chronic Kidney Disease (CKD): A long-term condition where the kidneys gradually lose their ability to filter waste and excess fluids from the blood effectively.
  • Type 2 Diabetes (T2D): A chronic condition that affects the way your body processes blood sugar (glucose), characterized by high blood sugar levels due to insulin resistance or insufficient insulin production.
  • Mineralocorticoid Receptor Antagonist (MRA): A class of drugs that block the effects of aldosterone, a hormone that can contribute to heart and kidney damage when present in excess.
  • Urine Albumin-to-Creatinine Ratio (UACR): A test that measures the amount of albumin (a protein) in your urine compared to creatinine, used to detect kidney damage.
  • Estimated Glomerular Filtration Rate (eGFR): A measure of how well your kidneys are filtering waste from your blood, calculated using a blood test and other factors like age and gender.
  • Primary Aldosteronism: A condition where the adrenal glands produce too much of the hormone aldosterone, leading to high blood pressure and sometimes low potassium levels.
  • Hyperkalemia: A condition where potassium levels in the blood are higher than normal, which can be a side effect of some medications and can affect heart function.
  • Cardio-Ankle Vascular Index (CAVI): A measure of arterial stiffness from the heart to the ankles, used to assess overall vascular health and risk of cardiovascular disease.

References

  1. https://clinicaltrials.eu/trial/study-to-find-treatments-for-chronic-kidney-disease-using-finerenone-in-patients-with-standard-care/
  2. https://clinicaltrials.gov/study/NCT05924620
  3. https://clinicaltrials.gov/study/NCT06381323
  4. https://clinicaltrials.gov/study/NCT06457074
  5. https://clinicaltrials.gov/study/NCT04881994
  6. https://clinicaltrials.gov/study/NCT06608212
  7. https://clinicaltrials.gov/study/NCT04908436
  8. https://clinicaltrials.gov/study/NCT05814770
  9. https://clinicaltrials.gov/study/NCT05887817
  10. https://clinicaltrials.gov/study/NCT06164379