Finerenone, marketed as Kerendia, reduces the risk of kidney failure and cardiovascular events in adults with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). According to clinical trial data, the drug slows the decline of the estimated glomerular filtration rate (eGFR) and lowers the incidence of heart failure hospitalizations.
How does finerenone protect the kidneys and heart?
Finerenone is a non-steroidal mineralocorticoid receptor antagonist (nsMRA). It blocks the overactivation of mineralocorticoid receptors, which according to research, helps reduce inflammation and fibrosis in the heart and kidneys. Unlike older steroidal MRAs like spironolactone, finerenone’s non-steroidal structure allows it to bind more selectively to receptors, potentially reducing certain side effects while maintaining cardioprotective and renoprotective effects.
The drug targets the renin-angiotensin-aldosterone system (RAAS). When this system is overactive, it leads to sodium retention and tissue scarring. By blocking these receptors, finerenone limits the damage to the kidney’s filtration units, which helps maintain kidney function over a longer period.
What are the proven benefits for patients with T2D and CKD?
Data from the FIDELIO-DKD trial showed that finerenone significantly reduced the risk of kidney failure and a sustained decline in eGFR. The study found that patients taking finerenone had a lower risk of progressing to end-stage kidney disease (ESKD) compared to those receiving a placebo.
The FIGARO-DKD trial focused on cardiovascular outcomes. According to the study results, finerenone reduced the risk of cardiovascular death and hospitalization for heart failure. When researchers combined data from both FIDELIO-DKD and FIGARO-DKD, the evidence showed a consistent reduction in composite kidney and cardiovascular events across the patient population.
Does finerenone work for patients without diabetes?
Recent evidence suggests finerenone’s benefits extend beyond patients with type 2 diabetes. Research reported by AusDoc indicates that finerenone slows eGFR decline in patients with CKD who do not have diabetes. This finding suggests the drug’s mechanism of reducing inflammation and fibrosis is effective regardless of whether the kidney disease was caused by diabetes or other etiologies.
This expansion of potential use is significant because it addresses a broader range of chronic kidney disease etiologies. By treating the underlying inflammatory process rather than just the diabetic complication, the drug may provide a broader safety net for patients across various stages of cardiovascular-kidney-metabolic (CKM) syndrome.
What does real-world evidence show via the FINEXPLORER study?
The FINEXPLORER study provides real-world data to complement controlled clinical trials. According to reports from TipRanks, the study monitors how finerenone