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Nephrol Ther. 2017 Apr;13 Suppl 1:S47-S53. doi: 10.1016/j.nephro.2017.02.003.

Renin-angiotensin system blockade: Finerenone.

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Instituto de Investigación imas, Madrid, Spain; Unidad de Hipertensión, Hospital 12 de Octubre, Departamento de Medicina Preventiva y Salud Publica, Universidad Autónoma, Avda de Cordoba s/n, 28041 Madrid, Spain; Escuela de Estudios Postdoctorales e Investigación, Universidad Europea de Madrid, Madrid, Spain. Electronic address:
Departamento de Farmacologia, Facultad de Medicina, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares, Madrid, Spain.


Finerenone is a novel selective nonsteroidal mineralocorticoid receptor antagonist. Results in preclinical studies showed that lower doses of finerenone were needed to achieve similar cardiorenal protective effects compared to both spironolactone and eplerenone and phase II studies in finerenone in patients with heart failure, type-2 diabetes mellitus and/or chronic kidney disease are encouraging as the drug is effective and safe in patients on renin-angiotensin system inhibitors (significant reduction in albuminuria and a low rate of hyperkalemia), but the primary end points were "soft" end points (serum potassium, estimated glomerular filtration rate, albuminuria, N-terminal prohormone B-type natriuretic peptide levels). Thus, further, large-scale, long-term phase III trials are needed to confirm whether the greater affinity and selectivity is translated into improved clinical outcomes.


Albuminuria; Aldosterone; Finerenone; Heart failure; Hypertension; Non-steroideal mineralocorticoid receptor antagonists

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