Finerenone is a nonsteroidal antimineralocorticoid that is in phase III clinical trials for the treatment of chronic kidney disease in people with type II diabetes.
It is distinct from steroidal mineralcorticoid receptor antagonists, such as spironolactone.
Trade name Kerendia
It has less relative affinity to other steroid hormone receptors than currently available antimineralocorticoids such as eplerenone and spironolactone, which should result in fewer adverse effects like gynaecomastia, impotence, and low libido.
Routes of administration Oral
Pregnancy category AU: D
Finerenone blocks mineralocorticoid receptors, which makes it a potassium-sparing diuretic.
Finerenone, used to reduce the risk of kidney function decline, kidney failure, cardiovascular death, non-fatal heart attacks, and hospitalization for heart failure in adults with chronic kidney disease associated with type 2 diabetes.
In patients with heart failure, and mildly reduced or preserved ejection fraction, finerenone resulted in significantly lower rate of composite total worsening heart failure and events, and death from cardiovascular causes than placebo.
Unlike currently marketed antimineralocorticoids, finerenone is not a steroid but a dihydropyridine derivative.
In the Phase II ARTS-DN study, finerenone dose-dependently reduces urine albumin to creatinine ratio in patients with diabetic kidney disease.
Among patients with type two diabetes and stage 2 to 4 chronic kidney disease with moderate elevated albuminuria or stage one or two chronic kidney disease with severely elevated albuminuria, finerenone improves cardiovascular outcomes is compared with placebo.
Common side effects include hyperkalemia, hypotension and hyponatremia.
Finerenone has less relative affinity to other steroid hormone receptors than currently available aldosterone antagonists such as eplerenone and spironolactone, which should result in fewer adverse effects like gynaecomastia, impotence, and low libido.
Finerenone may be less likely to cause kidney dysfunction and hyperkalemia, then spironolactone.
In the Phase II ARTS-DN study, finerenone dose-dependently reduced urine albumin to creatinine ratio in patients with diabetic kidney disease.
Non-steroidal mineralcorticoid receptor antagonist reduced morbidity and mortality among patients with heart failure and reduced ejection fraction.
In patients with heart failure and mildly reduced the preserved ejection fraction, finerenone results and significantly lower rate of composite of total worsening heart, failure, events, and death from cardiovascular causes, than placebo.
In the FINEARTS-HF trial finerenone showed improvement in patients with heart failure with LVEF of 40% or greater with lower rate of worsening heart failure events in death from cardiovascular disease, than placebo.