finerenone (Kerendia)

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Indications

* improves urine albumin/creatinine

* no effect on GFR[1]

Benefit/risk

* CKD progression: >40% decrease in eGFR relative to baseline for >4 weeks

Dosage

Tablets: 10 mg, 20 mg

Monitor

Adverse effects

* causes less hyperkalemia than spironolactone or eplerenone

* does not cause gynecomastia

Mechanism of action

Clinical trials

More general terms

References

  1. 1.0 1.1 Bakris GL, Agarwal R, Chan JC et al Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy. A Randomized Clinical Trial JAMA. 2015;314(9):884-894 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26325557 <Internet> http://jama.jamanetwork.com/article.aspx?articleID=2432163
  2. 2.0 2.1 2.2 Bakris GL, Agarwal B, Anker SD et al Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med. 2020. Oct 3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33264825 https://www.nejm.org/doi/full/10.1056/NEJMoa2025845
    Ingelfinger JR, Rosen CJ Finerenone - Halting Relative Hyperaldosteronism in Chronic Kidney Disease. N Engl J Med. 2020. Oct 3. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33095527 https://www.nejm.org/doi/full/10.1056/NEJMe2031382
  3. 3.0 3.1 Pitt B, Filippatos G, Agarwal R et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes. N Engl J Med 2021 Aug 28; PMID: https://www.ncbi.nlm.nih.gov/pubmed/34449181 https://www.nejm.org/doi/10.1056/NEJMoa2110956
  4. 4.0 4.1 Pitt B, Agarwal R, Anker SD et al Association of Finerenone Use With Reduction in Treatment-Emergent Pneumonia and COVID-19 Adverse Events Among Patients With Type 2 Diabetes and Chronic Kidney Disease. A FIDELITY Pooled Secondary Analysis. JAMA Netw Open. 2022;5(10):e2236123 PMID: https://www.ncbi.nlm.nih.gov/pubmed/36287567 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2797719
  5. 5.0 5.1 5.2 Agarwal R, Tu W, Farjat AE et al Impact of Finerenone-Induced Albuminuria Reduction on Chronic Kidney Disease Outcomes in Type 2 Diabetes. A Mediation Analysis. Ann Intern Med. 2023. Dec 5 PMID: https://www.ncbi.nlm.nih.gov/pubmed/38048573 https://www.acpjournals.org/doi/10.7326/M23-1023
  6. 6.0 6.1 Solomon SD et al. Finerenone in heart failure with mildly reduced or preserved ejection fraction. N Engl J Med 2024 Sep 1; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/39225278 https://www.nejm.org/doi/10.1056/NEJMoa2407107
  7. Medscape: finerenone (Rx) https://reference.medscape.com/drug/kerendia-finerenone-4000168

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