Finerenone

(Kerendia®)

Finerenone

Drug updated on 5/17/2024

Dosage FormTablets (oral; 10 mg, 20 mg)
Drug ClassNon-steroidal mineralocorticoid receptor antagonists
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated to reduce the risk of sustained eGFR decline, end stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D).

Latest News

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Summary
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  • Finerenone (Kerendia) is indicated to reduce the risk of sustained eGFR decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease associated with type 2 diabetes.
  • Eighteen studies were reviewed to gather information about this drug's efficacy and safety profile.
  • Compared to GLP1-RA and SGLT-2 inhibitors used for similar indications, finerenone shows comparable efficacy in reducing major adverse cardiovascular events (MACE) and slowing the progression of kidney disease. It also offers significant protection against hospitalization due to heart failure, which is not observed with GLP1-RAs.
  • In terms of renal protection compared to placebo or other mineralocorticoid receptor antagonists like spironolactone or eplerenone, finerenone has been found superior in delaying the deterioration of kidney function. This includes a reduction in the urine albumin creatinine ratio (UACR) as well as prevention of a decline in estimated glomerular filtration rate (eGFR).
  • The safety profile indicates an increased risk of hyperkalemia during therapy compared to both placebo and other therapeutic agents, but the overall side effect profile remains comparable. Compared specifically with MRAs, it might offer better safety outcomes, including lesser incidents related to hyperkalemia than spironolactone, along with improvements on the renal front without sexual side effects.
  • For patients with established atherosclerotic cardiovascular diseases, consistent effectiveness was noted by studies regarding the reduction of risks related to MACE while using finerenone.
  • In populations suffering from Type 2 Diabetes Mellitus alongside Chronic Kidney Disease, benefits are particularly notable, showcasing a dual cardiorenal protective effect offered by this drug.
  • Finerenone presents itself as a promising option when comparing within its class and beyond, offering unique benefits, especially concerning hospitalizations due to heart failure and progression of kidney disease. Its efficacy in reducing MACE is on par with other leading therapies such as GLP1-RA and SGLT-2 inhibitors while offering a differentiated benefit in heart failure hospitalization prevention. Despite the challenge posed by hyperkalemia requiring monitoring, it does not detract significantly from its overall favorable benefit-risk profile.

Product Monograph / Prescribing Information

Document TitleYearSource
Kerendia (finerenone) Prescribing Information.2022Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Effects of finerenone and glucagon-like peptide 1 receptor agonists on cardiovascular and renal outcomes in type 2 diabetes mellitus: a systematic review and meta-analysis.2024Diabetology & Metabolic Syndrome
Finerenone in type 2 diabetes and renal outcomes: A random-effects model meta-analysis.2023Frontiers in Endocrinology
Efficacy and safety of finerenone for prevention of cardiovascular events in type 2 diabetes mellitus with chronic kidney disease: a meta-analysis of randomized controlled trials.2023Journal of Cardiovascular Pharmacology
Efficacy and safety of finerenone in chronic kidney disease and type 2 diabetes patients: a systematic review and meta-analysis.2023Annals of Medicine & Surgery
A systematic review and meta-analysis on the efficacy and safety of finerenone therapy in patients with cardiovascular and chronic kidney diseases in type 2 diabetes mellitus.2023Cureus
Benefits and harms of drug treatment for type 2 diabetes: Systematic review and network meta-analysis of randomised controlled trials.2023BMJ (Clinical Research ed.)
Network meta-analysis of mineralocorticoid receptor antagonists for diabetic kidney disease.2022Frontiers in Pharmacology
Finerenone in diabetic kidney disease: a systematic review and critical appraisal.2022Diabetes & Metabolic Syndrome
Efficacy and safety of finerenone in chronic kidney disease: a systematic review and meta-analysis of randomized clinical trials.2022Frontiers in Pharmacology
Meta-analysis of the efficacy and safety of finerenone in diabetic kidney disease.2022Kidney and Blood Pressure Research
Efficacy and safety of non-steroidal mineralocorticoid receptor antagonists in patients with chronic kidney disease and type 2 diabetes: a systematic review incorporating an indirect comparisons meta-analysis.2022Frontiers in Pharmacology
Efficacy and safety of finerenone in chronic kidney disease associated with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials.2022European Journal of Clinical Pharmacology
Effect of finerenone on cardiovascular events in kidney disease and/or diabetes: a meta analysis of randomized control trials.2022International Urology and Nephrology
Network meta-analysis on the effects of finerenone versus SGLT2 inhibitors and GLP-1 receptor agonists on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and chronic kidney disease.2022Cardiovascular Diabetology
Comparison the effects of finerenone and SGLT2i on cardiovascular and renal outcomes in patients with type 2 diabetes mellitus: a network meta-analysis.2022Frontiers in Endocrinology
Efficacy and safety of finerenone in patients with chronic kidney disease: a systematic review with meta-analysis and trial sequential analysis.2021Annals of Palliative Medicine
Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease.2020The Cochrane Database of Systematic Reviews
Comparative efficacy and safety of mineralocorticoid receptor antagonists in heart failure: a network meta-analysis of randomized controlled trials.2019Heart Failure Reviews

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