Non-steroidal mineralocorticoid receptor antagonism for the treatment of cardiovascular and renal disease

Bramlage P, Swift SL, Thoenes M, Minguet J, Ferrero C, Schmieder R (2016)

Publication Type: Journal article, Erratum

Publication year: 2016

Journal

European Journal of Heart Failure Oxford University Press (OUP): Policy B

Book Volume: 18

Pages Range: 28-37

Journal Issue: 1

DOI: 10.1002/ejhf.444

Abstract

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.

Authors with CRIS profile

Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

Institut für Pharmakologie und präventive Medizin (IPPMed GmbH) DE Germany (DE) University of Seville / Universidad de Sevilla ES Spain (ES)

How to cite

APA:

Bramlage, P., Swift, S.L., Thoenes, M., Minguet, J., Ferrero, C., & Schmieder, R. (2016). Non-steroidal mineralocorticoid receptor antagonism for the treatment of cardiovascular and renal disease. European Journal of Heart Failure, 18(1), 28-37. https://doi.org/10.1002/ejhf.444

MLA:

Bramlage, Peter, et al. "Non-steroidal mineralocorticoid receptor antagonism for the treatment of cardiovascular and renal disease." European Journal of Heart Failure 18.1 (2016): 28-37.

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