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Finerenone and cardiorenal protection : from controlled clinical trials to real-life clinical practice
Philips JC , Radermecker RP , Scheen AJ
Rev Med Liege 2024, 79(11),739-744Abstract : Finerenone is a selective non-steroidal antagonist of the mineralocorticoid receptor. This molecule significantly reduces cardiovascular morbidity and mortality and slows the progression of kidney disease in people with type 2 diabetes (T2D) and chronic kidney disease as demonstrated in two huge randomised controlled trials versus placebo (FIDELIO-DKD and FIGARO-DKD). Recent data provide additional information about both the efficacy and safety of this molecule in patients with or without T2D presenting heart failure (FINEARTS-HF). These results obtained in controlled trials are being confirmed in observational real-life studies (FINE-REAL) and several other studies devoted to heart failure. Also, finerenone is currently being tested among various special populations outside T2D. Several international recommendations in nephrology, cardiology, and diabetology support the use of finerenone in patients with T2D considered at high and very high cardiovascular and renal risk.
