Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
Agarwal R, Ruilope LM, Ruiz-Hurtado G, Haller H, Schmieder R, Anker SD, Filippatos G, Pitt B, Rossing P, Lambelet M, Nowack C, Kolkhof P, Joseph A, Bakris GL (2023)
Publication Type: Journal article
Publication year: 2023
Journal
Book Volume: 41
Pages Range: 295-302
Journal Issue: 2
DOI: 10.1097/HJH.0000000000003330
Abstract
OBJECTIVE: Finerenone is a selective nonsteroidal mineralocorticoid receptor antagonist with a short half-life. Its effects on cardiorenal outcomes were thought to be mediated primarily via nonhemodynamic pathways, but office blood pressure (BP) measurements were insufficient to fully assess hemodynamic effects. This analysis assessed the effects of finerenone on 24-h ambulatory BP in patients with chronic kidney disease and type 2 diabetes. METHODS: ARTS-DN (NCT01874431) was a phase 2b trial that randomized 823 patients with type 2 diabetes and chronic kidney disease, with urine albumin-to-creatinine ratio ≥30 mg/g and estimated glomerular filtration rate of 30-90 ml/min per 1.73 m2 to placebo or finerenone (1.25-20 mg once daily in the morning) administered over 90 days. Ambulatory BP monitoring (ABPM) over 24 h was performed in a subset of 240 patients at screening, Day 60, and Day 90. RESULTS: Placebo-adjusted change in 24-h ABPM systolic BP (SBP) at Day 90 was -8.3 mmHg (95% confidence interval [CI], -16.6 to 0.1) for finerenone 10 mg (n = 27), -11.2 mmHg (95% CI, -18.8 to -3.6) for finerenone 15 mg (n = 34), and -9.9 mmHg (95% CI, -17.7 to -2.0) for finerenone 20 mg (n = 31). Mean daytime and night-time SBP recordings were similarly reduced and finerenone did not increase the incidence of SBP dipping. Finerenone produced a persistent reduction in SBP over the entire 24-h interval. CONCLUSIONS: Finerenone reduced 24-h, daytime, and night-time SBP. Despite a short half-life, changes in BP were persistent over 24 h with once-daily dosing in the morning.
Authors with CRIS profile
Involved external institutions
Veterans Health Administration (VHA)
United States (USA) (US)
Research Institute Hospital 12 de Octubre (Imas12)
Spain (ES)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Berliner Institut für Gesundheitsforschung (BIH)
Germany (DE)
University of Michigan
United States (USA) (US)
Steno Diabetes Center
Denmark (DK)
Chrestos Concept GmbH & Co. KG
Germany (DE)
Bayer AG
Germany (DE)
University of Chicago
United States (USA) (US)
United States (USA) (US)
Research Institute Hospital 12 de Octubre (Imas12)
Spain (ES)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Berliner Institut für Gesundheitsforschung (BIH)
Germany (DE)
University of Michigan
United States (USA) (US)
Steno Diabetes Center
Denmark (DK)
Chrestos Concept GmbH & Co. KG
Germany (DE)
Bayer AG
Germany (DE)
University of Chicago
United States (USA) (US)
How to cite
APA:
Agarwal, R., Ruilope, L.M., Ruiz-Hurtado, G., Haller, H., Schmieder, R., Anker, S.D.,... Bakris, G.L. (2023). Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes. Journal of Hypertension, 41(2), 295-302. https://dx.doi.org/10.1097/HJH.0000000000003330
MLA:
Agarwal, Rajiv, et al. "Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes." Journal of Hypertension 41.2 (2023): 295-302.
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