Finerenone: A Novel Mineralocorticoid Receptor Antagonist in Chronic Kidney Disease Associated with Type 2 Diabetes
Keywords:
finerenone, non-steroidal mineralocorticoid receptor antagonist, diabetic kidney diseaseAbstract
Mineralocorticoid receptor (MR) antagonist is well utilized in treating patients with diabetic kidney disease or heart failure patients. Its effects upon blocking aldosterone from over binding to MR leads to reducing cell production of oxidative stress, inflammation, and fibrosis in kidney and heart, and thereby slowing disease progression. Two steroidal MR antagonists, spironolactone and eplerenone, are underutilized in such indication. This is due to the increased risk of severe adverse events such as hyperkalemia and worsening kidney function. Finerenone, an oral novel non-steroidal MR antagonist with the different pharmacological properties compared to previous MR antagonists, is thus developed. The drug does not cause gynecomastia or affect blood pressure. It is now approved by the US Food and Drug Administration in 2021 for the indication of reducing the risk of progressive chronic kidney disease (CKD) and complications of cardiovascular disease in patients with CKD associated with type 2 diabetes. The monitoring of hyperkalemia and kidney function is recommended during use of finerenone in such patients. In addition, long-term adverse events monitoring should be further performed.
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