Premium
Non‐steroidal mineralocorticoid receptor antagonism for the treatment of cardiovascular and renal disease
Author(s) -
Bramlage Peter,
Swift Stephanie L.,
Thoenes Martin,
Minguet Joan,
Ferrero Carmen,
Schmieder Roland E.
Publication year - 2016
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.444
Subject(s) - medicine , mineralocorticoid receptor , primary aldosteronism , kidney disease , hyperaldosteronism , mineralocorticoid , spironolactone , eplerenone , heart failure , aldosterone , intensive care medicine , pharmacology
Pharmaceutical antagonism of the mineralocorticoid receptor ( MR ) can protect against organ damage caused by elevated aldosterone levels in patients experiencing heart failure ( HF ), chronic kidney disease ( CKD ), primary aldosteronism, and hypertension. While traditional steroid‐based MR antagonists effectively reduce mortality rates and extend patient survival, their broad application has been limited by significant side effects, most notably hyperkalaemia. Recently, finerenone ( BAY 94‐8862) has emerged as a next‐generation non‐steroidal dihydropyridine‐based MR antagonist designed to minimize off‐target effects while maintaining potent efficacy. In this review, the outcomes of finerenone therapy in several diseases associated with MR activity are explored. The (pre‐) clinical efficacy of finerenone is compared with that of traditional steroid‐based MR antagonists. Finally, recent and ongoing clinical trials using finerenone to treat chronic HF , CKD , and diabetic nephropathy are discussed. Taken together, pre‐clinical and clinical evidence suggests that finerenone may achieve equivalent organ‐protective effects with reduced levels of electrolyte disturbance compared with traditional steroid‐based MR antagonists. This supports further clinical development of finerenone for the treatment of cardiovascular and renal disease.