Finerenone

Indications :

• Should be considered in patients with Type 2 Diabetes (DM2) w/ persistent albuminuria despite maximally tolerated renin-angiotensin system inhibition, and normal potassium levels.
  • In 2 randomized, double-blind, placebo-controlled, multicenter studies in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (FIDELIO-DKD and FIGARO-DKD), the placebo-corrected relative reduction in urinary albumin-to-creatinine ratio (UACR) in patients randomized to finerenone was 31% (95% CI, 29% to 34%) and 32% (95% CI, 30% to 35%), respectively at month 4 and remained stable for the duration of the trial.
  • In another randomized, double-blind, placebo-controlled, multicenter dose finding study (ARTS DN) in adults with CKD and type 2 diabetes, the placebo-controlled relative reduction in UACR at day 90 was 25% and 38% in patients treated with finerenone 10 mg and 20 mg once daily, respectively.

Contraindications:

• Hyperkalemia
• CYP3A4 substrate and concomitant use with a strong CYP3A4 inhibitor increases finerenone exposure very significantly, which may increase the risk of adverse reactions due to the drug. Concomitant use of finerenone with strong CYP3A4 inhibitors is contraindicated.

Dosing :

MoA :

• Nonsteroidal, selective antagonist of the mineralocorticoid receptor (MR).
• High potency and selectivity for the MR and has no relevant affinity for androgen, progesterone, estrogen, and glucocorticoid receptors.

Pharmacokinetics :

Toxicities/Monitoring :

References: