Kerendia (finerenone) / Bayer - LARVOL DELTA

EmFin-Nx: Efficacy and Safety of Finerenone and Empagliflozin in Delaying Renal Function Progression After Radical Nephrectomy in High-Risk CKD Patients: A Multicenter RCT (clinicaltrials.gov) - P2 | N=10 | Terminated | Sponsor: Jinling Hospital, China | N=100 ➔ 10 | Trial completion date: Dec 2027 ➔ Oct 2025 | Recruiting ➔ Terminated | Trial primary completion date: Jan 2027 ➔ Oct 2025; The patient enrollment rate is proceeding too slowly

Enrollment change • Trial completion date • Trial primary completion date • Trial termination • Chronic Kidney Disease • Genito-urinary Cancer • Kidney Cancer • Nephrology • Oncology • Renal Cell Carcinoma • Renal Disease • Solid Tumor

Efficacy and Safety of Finerenone in Kidney Transplant Patients. (PubMed, J Clin Med) - " Finerenone is a promising adjunct therapy in kidney transplant patients for reducing proteinuria without impairing renal function for those patients who can tolerate it. However, in the early phase of treatment initiation, patients should be closely monitored for adverse effects including hyperkalemia."

Journal • Chronic Kidney Disease • Nephrology • Pain • Renal Disease • Transplantation

Finerenone: A game changer for chronic kidney disease patients with type 2 diabetes. (PubMed, J Pak Med Assoc) - No abstract available

Journal • Chronic Kidney Disease • Diabetes • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Diabetes Mellitus and Chronic Kidney Disease: The Future Is Being Surpassed. (PubMed, J Clin Med) - "(5) The mineralocorticoid receptor antagonist (MRA) finerenone has been tested in RCTs as a kidney protective agent...Many novel agents-many of them proven not only for DM management but also for the treatment of obesity with or without DM or heart failure (HF)-are now in development and may be added to the five classical pillars: other non-steroidal MRA (balcinrenone); aldosterone synthase inhibitors (baxdrostat and vicadrostat); other GLP-1 RA (tirzepatide, survodutide, retatrutide, and cagrilintide); ET1 R antagonists, (zibotentan); and soluble guanylate cyclase activators (avenciguat). These new agents aim to slow disease progression further and reduce cardiovascular risk. Future strategies rely on integrated, patient-centered approaches and personalized therapy to curb renal disease and its related complications."

Journal • Review • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Genetic Disorders • Heart Failure • Metabolic Disorders • Nephrology • Obesity • Renal Disease

Real-World Impact of Finerenone on Albuminuria in Patients with Diabetes and CKD. (PubMed, Int J Mol Sci) - "This reduction was more pronounced in patients who experienced an initial eGFR dip ≥ 20%. Finerenone was generally well tolerated and appears to be a promising therapeutic strategy for reducing albuminuria in this population."

Journal • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease

Triple therapy of RAS inhibitors, dapagliflozin, and finerenone in diabetic kidney disease patients with nephrotic-range proteinuria: a real-world study. (PubMed, Sci Rep) - "No serious adverse events, such as hyperkalemia (> 5.5 mmol/L), were observed. This real-world study shows the efficacy of triple therapy with RAS inhibitors, dapagliflozin, and finerenone in DKD patients with NRP, along with a favorable safety profile."

Journal • Real-world evidence • Retrospective data • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Timing of Cardiovascular and Kidney Benefits With Finerenone in Heart Failure and Chronic Kidney Disease With Type 2 Diabetes. (PubMed, J Am Coll Cardiol) - No abstract available

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Temporal Changes in SGLT2 Inhibitor and GLP-1 Receptor Agonist Use in Patients with Chronic Kidney Disease and Type 2 Diabetes, 2012-2023: A US Cohort Study. (PubMed, Diabetes Ther) - P | "These findings inform and contextualize future studies assessing cardiorenal outcomes for these and additional treatments, including finerenone, for individuals with CKD and type 2 diabetes."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Finerenone-Related Risk of Hypotension in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. (PubMed, JACC Heart Fail) - P3 | "In this prespecified analysis of the FINEARTS-HF trial, finerenone led to higher rates of post-baseline SBP <100 mm Hg and investigator-reported hypotension. Although hypotension should not prompt automatic treatment discontinuation, these patients should be carefully monitored. (Study to Evaluate the Efficacy (Effect on Disease) and Safety of Finerenone in Participants With Heart Failure and Left Ventricular Ejection Fraction (Proportion of Blood Expelled Per Heart Stroke) Greater or Equal to 40% [FINEARTS-HF]; NCT04435626.)."

Journal • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Hypotension • Metabolic Disorders

FINE-MECH: Finerenone and Cardiac Remodeling (clinicaltrials.gov) - P3 | N=156 | Not yet recruiting | Sponsor: Subodh Verma

New P3 trial • Cardiovascular • Congestive Heart Failure • Heart Failure

Interplay Between Heart Failure Events, New-Onset Diabetes, and Finerenone in Heart Failure With Mildly Reduced or Preserved Ejection Fraction. (PubMed, Diabetes Care) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders

Effectiveness of SGLT2 inhibitors, incretin-based therapies, and finerenone on cardiorenal outcomes: a meta-analysis and network meta-analysis. (PubMed, Cardiovasc Diabetol Endocrinol Rep) - No abstract available

Journal • Retrospective data • Review

Finerenone and Cardiovascular Outcomes According to Baseline Kidney Function in Patients With Heart Failure: The FINEARTS-HF Trial. (PubMed, JACC Heart Fail) - "In the FINEARTS-HF trial (where the target dose of finerenone was determined by baseline kidney function), the effect of finerenone to reduce the composite of cardiovascular death and total HF events did not significantly differ across a range of baseline eGFR and UACR."

Clinical • Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

Effects of finerenone on arterial stiffness and cardiorenal biomarkers in patients with type 2 diabetes and chronic kidney disease: a randomised placebo-controlled mechanistic trial (FIVE-STAR). (PubMed, Cardiovasc Diabetol) - P4 | "Finerenone did not affect changes in vascular stiffness but led to a significant and sustained reduction in albuminuria in patients with T2D and CKD. The clinical benefits of finerenone may result from lowering intraglomerular pressure rather than from its effect on vascular stiffness."

Biomarker • Journal • Cardiovascular • Chronic Kidney Disease • Diabetes • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Managing hypertension in a patient with diabetic kidney disease: A clinical case. (PubMed, J Am Assoc Nurse Pract) - "The newly approved nonsteroidal mineralocorticoid receptor antagonist, finerenone, sodium-glucose cotransporter-2 inhibitors, and glucagon-like peptide-1 receptor agonists have been shown to offer kidney- and heart-healthy benefits, making them integral to treatment strategies...This case underscores the necessity of a patient-centered approach to managing hypertension in DKD. By using a comprehensive strategy, primary care nurse practitioners can improve BP control, slow renal disease progression, reduce cardiac events, and prolong the life of these high-risk patients."

Journal • Cardiovascular • Diabetic Nephropathy • Hypertension • Nephrology • Renal Disease

Re"FINE"ing Our Understanding of Finerenone in Heart Failure Across the Spectrum of Cardio-Kidney-Metabolic Risk. (PubMed, JACC Heart Fail) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Metabolic Disorders

Effect of finerenone on proteinuria reduction in IgA nephropathy. (PubMed, Ren Fail) - "The eGFR was relatively stable during follow-up. The protein-to-creatinine ratio was significantly reduced after finerenone treatment in IgA nephropathy patients with full supportive therapy, and the eGFR was stable during follow-up."

Journal • Cardiovascular • Chronic Kidney Disease • Diabetes • Glomerulonephritis • IgA Nephropathy • Metabolic Disorders • Renal Disease • Type 2 Diabetes Mellitus

Demystifying the Impact of Kidney Risk on Finerenone Effects in Heart Failure. (PubMed, JACC Heart Fail) - No abstract available

Journal • Cardiovascular • Congestive Heart Failure • Heart Failure • Renal Disease

The effect of finerenone on arterial stiffness in patients with diabetic kidney disease: A pilot study. (PubMed, Clin Nephrol) - "Our findings indicate that after 6 months of treatment, finerenone led to a decrease in central arterial stiffness and interstitial lung water. Kidney function remained stable, no clinically significant hyperkalemia occurred."

Journal • Cardiovascular • Diabetic Nephropathy • Nephrology • Renal Disease

Efficacy and safety of add-on treatment with finerenone in patients with diabetic kidney disease already treated with SGLT-2 inhibitors. (PubMed, Clin Nephrol) - "In this real-world cohort, the renoprotective combination therapy with added finerenone was associated with a further reduction in albuminuria and proteinuria. The treatment was well tolerated with a minimal increase in potassium levels and generally stable renal function."

Journal • Diabetic Nephropathy • Nephrology • Renal Disease

Evidence-based validation of cardiovascular benefits from novel MRAs in type 2 diabetes: A meta-analysis of over 30,000 patients. (PubMed, J Diabetes Complications) - "This study provides high-certainty evidence supporting MRAs in reducing MACE and heart failure hospitalization, and moderate-certainty evidence for benefits on cardiovascular mortality. Cardioprotective effects may involve Ras, IL-17, and relaxin signaling."

Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Type 2 Diabetes Mellitus • EGFR • IL17A • MAPK10 • MMP1 • NOS2 • PACERR • PTGS2

Finerenone Versus Spironolactone for Heart Failure with Preserved Ejection Fraction. (PubMed, Cardiovasc Drugs Ther) - "In this first direct comparison of MRAs in HFpEF, finerenone demonstrated broadly comparable effectiveness and safety to spironolactone. While these observations are hypothesis-generating, prospective studies are warranted to confirm these findings and inform therapeutic decision-making."

Journal • Acute Kidney Injury • Cardiovascular • Congestive Heart Failure • Heart Failure • Myocardial Infarction • Nephrology • Renal Disease

The use of predictive, preventive, and personalized medical approaches to optimize hypertension management. (PubMed, EPMA J) - "The 3PM framework leverages AI-driven integration of multi-omics, retinal imaging like ViT models, and hemodynamic profiling for risk prediction and treatment response forecasting; genetic profiling such as MTHFR, UMOD variants, urinary proteomics (CKD273 classifier), and microbiome-guided nutrition for early intervention; and pharmacogenomics, digital phenotyping like smartphone-guided dosing, and novel therapies such as aprocitentan and finerenone for personalized efficacy. Specific findings include aprocitentan reducing systolic BP by -15.3 mmHg in resistant hypertension, UMOD-guided torasemide use lowering BP by 8.5 mmHg in carriers, and microbiome-based nutrition reducing systolic BP by 14% in hyperglycemic patients...3PM transforms hypertension management by enabling proactive, individualized care. However, rigorous validation, affordable diagnostics, pragmatic trials, and equitable access are essential to bridge translational gaps and..."

Journal • Review • Cardiovascular • Diabetes • Hypertension • MTHFR

Regulation of Klotho Production by Mineralocorticoid Receptor Signaling in Renal Cell Lines. (PubMed, Biomolecules) - "Using four renal cell lines, Madin-Darby canine kidney (MDCK), normal rat kidney, subtype 52E (NRK-52E), human kidney 2 (HK2) cells, and primary renal proximal tubule epithelial cells (RPTECs), and the four most frequently prescribed mineralocorticoid receptor blockers, spironolactone, eplerenone, finerenone, and esaxerenone, we assessed Klotho gene expression by qRT-PCR and Klotho protein by Western blotting. To conclude, common mineralocorticoid receptor antagonists are characterized by highly diverse effects on Klotho in four renal cell lines. Further studies are needed to define the role of mineralocorticoid receptor blockade for Klotho production."

Journal • Preclinical • Endocrine Disorders • Fibrosis • Heart Failure • Immunology • Inflammation • Nephrology • Renal Disease • KL

Impact of Finerenone in Patients with Heart Failure and Reduced/Mildly Reduced Ejection Fraction, Diabetes Mellitus, and Chronic Kidney Disease. (PubMed, J Clin Med) - "Renal function and serum potassium remained stable during the whole study period (p > 0.05 for both). In this real-world study of patients with HFrEF/HFmrEF complicated by DM and CKD, finerenone was associated with significant improvements in NT pro-BNP and cardiac remodeling indices without worsening renal function or hyperkalemia."

Journal • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Nephrology • Renal Disease