Kerendia (finerenone) / Bayer - LARVOL DELTA

Nonsteroidal Mineralocorticoid Receptor Antagonists and Cardiovascular Events in Type 2 Diabetes: A Retrospective Study. (PubMed, Eur Heart J Cardiovasc Pharmacother) - "Finerenone demonstrated superior cardiovascular outcomes compared with spironolactone and eplerenone in patients with T2DM with significant reductions in MACE, mortality, and heart failure events."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Metabolic Disorders • Myocardial Infarction • Type 2 Diabetes Mellitus

Less Heart Failure But No Improvement in Quality of Life in FINEARTS-HF: Why the Disconnect? (PubMed, J Am Coll Cardiol) - No abstract available

HEOR • Journal • Cardiovascular • Congestive Heart Failure • Heart Failure

Finerenone and semaglutide: Role in heart failure with reduced ejection fraction. (PubMed, World J Cardiol) - "For decades, the cardiorenal protective effects of aldosterone blockage in patients with chronic kidney disease have been of significant interest. But due to multiple side effects, these trials were likely to stop."

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

Adverse effects of finerenone in patients with heart failure: a systematic review and meta-analysis. (PubMed, Front Cardiovasc Med) - "Compared to eplerenone, finerenone was associated with fewer TEAEs and TESAEs, with comparable discontinuation rates. Moreover, in patients with HFrEF, finerenone may offer lower risks of TEAEs, treatment discontinuation, and hyperkalemia than spironolactone, with similar rates of hypotension."

Adverse events • Journal • Retrospective data • Review • Cardiovascular • Congestive Heart Failure • Heart Failure • Hypotension

Therapeutic Effects of Finerenone and Exenatide on Diabetes-Induced Heart Failure: A Combined Approach Targeting Inflammation and Oxidative Stress. (PubMed, Eur J Pharmacol) - "Treatment with either finerenone or exenatide alone improved several parameters; however, the combination therapy provided the most substantial cardioprotective effects, with marked reductions in oxidative stress and inflammation and enhanced NRF2 expression. These findings suggest that the combined administration of finerenone and exenatide offers superior protection against diabetes-induced cardiac injury compared to monotherapies, supporting a dual-targeted therapeutic approach for diabetic cardiomyopathy."

Journal • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Type 1 Diabetes Mellitus • IL1B • IL6 • NFE2L2 • TNFA

Be CONFIDENT with the initial combination use of finerenone and SGLT-2 inhibitors (ERA 2025) - "Sponsored by Bayer AG"

Be CONFIDENT with the initial combination use of finerenone and SGLT-2 inhibitors (ERA 2025) - "Sponsored by Bayer AG"

THE CONFIDENCE TRIAL: EFFICACY/SAFETY OF COMBINING FINERENONE WITH EMPAGLIFLOZIN IN PEOPLE WITH CHRONIC KIDNEY DISEASE AND TYPE 2 DIABETES (ERA 2025) - P2 | "CONFIDENCE is a phase 2 trial comparing the efficacy and safety of dual finerenone and empagliflozin therapy to either agent alone in people with CKD and T2D. This trial will determine the potential role of simultaneous initiation and dual treatment with finerenone and SGLT2is in people with CKD and T2D."

Clinical • Late-breaking abstract • Acute Kidney Injury • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Hypotension • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Observation of the therapeutic effect of finerenone, a novel non-steroidal mineralocorticoid receptor antagonist, in patients with non-diabetic CKD (ERA 2025) - "Finerenone can effectively decrease proteinuria in patients with non-diabetic CKD, with little impacts on eGFR and sK+. Its efficacy does not depend on concurrent use of RASi and SGLT2i. It is expected to confer proteinuria remission in IgAN."

Clinical • Cardiovascular • Chronic Kidney Disease • Diabetic Nephropathy • Glomerulonephritis • IgA Nephropathy • Metabolic Disorders • Nephrology

Short-term effect of finerenone on albuminuria and potassium levels in patients with diabetic kidney disease: analysis in real clinical practice. (ERA 2025) - "In our real-world study of a population of patients with type 2 diabetes mellitus and albuminuria with varying degrees of eGFR, the administration of finerenone was safe and well-tolerated. As described in clinical trials, the initiation of the drug led to a slight increase in serum potassium, a decrease in albuminuria, and stability of eGFR during the 6-month follow-up. In the subgroup of patients previously treated with non-selective MRAs, a decrease in serum potassium levels was observed, but there was poorer control of albuminuria."

Clinical • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Fibrosis • Immunology • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus • CRP

Early clinical experience of finerenone in patient with chronic kidney disease and type 2 diabetes in real Life. Comparison with FIDELITY Pooled (ERA 2025) - "Due to high prevalence of DKD, understanding the real-world impact of finerenone is essential. Despite the small sample size, our registry includes older patients with lower eGFR and similar levels of UACR. We observed a significant decrease in albuminuria in patients without previous MRA, but higher incidence of hyperkalemia."

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

REAL-LIFE STUDY OF FINERENONE, EFFICACY AND SAFETY ASSESSMENT (ERA 2025) - "•Finerenone demonstrated a favorable safety profile with minimal treatment discontinuation (2/15 patients) and no significant increases in potassium levels in a real- world elderly population with advanced CKD. •A 29.11% reduction in microalbuminuria was observed after one month of treatment, although not reaching statistical significance (p=0.161), in patients with diabetic kidney disease receiving standard therapy. •Further research with larger sample sizes and extended follow-up periods is warranted to establish long-term efficacy and safety in real-world settings."

Clinical • Chronic Kidney Disease • Diabetic Nephropathy • Nephrology

Fine with finerenone in Croatia –advancing renal care for our diabetic chronic kidney disease patients (ERA 2025) - "Finerenone is effective in improving both treatment of CKD and proteinuria reduction in diabetic patients thus potentially reducing the proteinuria driven progression of CKD. The significant effects on albuminuria reduction seen as early as 3 months after the start of finerenone. In our cohort it is worth noting most likely add on effect of finereone to the one of SGLT2i and in some patients of GLP1 agonists."

Clinical • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Hypertension • Metabolic Disorders • Nephrology • Pulmonary Arterial Hypertension • Renal Disease • Type 1 Diabetes Mellitus • Type 2 Diabetes Mellitus

Non-Proteinuric Kidney Disease and Type II Diabetes: CKM (Cardio Kidney Metabolic) Parameters and Current Recommended Treatment Modalities (ERA 2025) - "SGLT2 inhibitors are recommended by the ADA for T2DM patients with cardiovascular risks, yet their uptake is 42.6% in this cohort. RAS inhibitors, despite guidelines against use in normotensive, normoalbuminuric patients, showed similar use to proteinuric CKD (40.5%). Finerenone use (4.2%) aligns with its indication in proteinuria, suggesting quadruple therapy may lead to non-proteinuric status."

Cardiovascular • Chronic Kidney Disease • Diabetes • Dyslipidemia • Genetic Disorders • Hypertension • Metabolic Disorders • Nephrology • Obesity • Renal Disease • Type 2 Diabetes Mellitus

Investigation of the Rac1-SGK1 Pathway and Therapeutic Effects of Finerenone and Rac1 Inhibition in a Fabry Disease Podocyte Model (ERA 2025) - "The control group (wild type; wt) and GLA-suppressed cells (Fabry podocytes) were treated with finerenone and Rac 1 inhibitor (NSC23766). This study is the first in the literature to demonstrate the involvement of the RAC1-SGK1 pathway including increased mineralocorticoid receptor, 11β-HSD1 and NOX5 gene expression and Rac1 protein levels in Fabry podocyte damage and to show the therapeutic effectiveness of finerenone, a non- steroidal mineralocorticoid receptor antagonist, as well as Rac1 inhibition. We believe that finerenone therapy, as a podocyte-protective treatment, may be effective in preventing Fabry nephropathy in the future.Figures: Figure 1. The results of GLA gene expression and GLA protein analyses (Western Blot) Figure 2."

Fabry Disease • Genetic Disorders • Glomerulonephritis • Renal Disease • NOX5

Hereditary Transthyretin Amyloidosis (ATTRv): finerenone along the spectrum of kidney and heart disease (ERA 2025) - "Anti-amyloid therapy included liver transplantation (n=13; 61.90%), tafamidis (n=5; 23.81%), and patisiran (n=3; 14.29%). In ATTRv, finerenone has shown efficacy in kidney protection, including in the setting of heart failure with preserved ejection fraction (HFpEF). It significantly reduces proteinuria (PCR) while demonstrating good tolerability, avoiding the deleterious hypotension associated with dysautonomia and minimizing complications related to neurogenic bladder. Furthermore, its use does not lead to significant changes in potassium levels."

Acute Kidney Injury • Amyloidosis • Cardiac Amyloidosis • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Fabry Disease • Genetic Disorders • Heart Failure • Hypotension • Infectious Disease • Nephrology • Renal Disease

Real-World Outcomes of Switching from steroidal mineralocorticoid receptor antagonists (sMRA) to Finerenone in Patients with Chronic Kidney Disease and Type 2 Diabetes (T2DM): A Multicenter Study in Madrid Community. (ERA 2025) - "This study aimed to evaluate renal function, albuminuria, and electrolytes in patients switched from spironolactone or eplerenone to finerenone in routine clinical practice. In real-world clinical practice, switching from sMRAs to finerenone in patients with CKD and T2D was associated with lower sK values with stable albuminuria and eGFR. These findings suggest finerenone as a safer alternative for patients at risk of sMRAs induced hyperkalemia, supporting its broader use in clinical practice."

Clinical • Real-world • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Dyslipidemia • Hypertension • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Effect of finerenone on eGFR slope across different levels of baseline albuminuria: Insights from FINEARTS-HF (ERA 2025) - "Among patients with HF and macroalbuminuria (at higher risk of kidney disease progression), finerenone slowed the decline in chronic eGFR slope to a clinically relevant greater extent than placebo"

Cardiovascular • Congestive Heart Failure • Heart Failure • Nephrology • Renal Disease

Real-world impact of finerenone on albuminuria in patients with diabetes and CKD (ERA 2025) - "Our results support that finerenone causes significant 30% albuminuria reduction after 3 months of treatment and an initial drop of eGFR that afterwards stabilizes in patients with CKD-DM. Moreover, the decrease of UACR after finerenone treatment seems to be greater in the group of A3 and in patients whose eGFR present an initial dip of ≥20% compared with their baseline. Finerenone was generally well tolerated, with little minor adverse events."

Clinical • Real-world • Real-world evidence • Acute Kidney Injury • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Heart Failure • Immunology • Inflammation • Metabolic Disorders • Nephrology • Renal Disease

Changes in albuminuria and the effect of finerenone on cardiovascular outcomes: Insights from FINEARTS-HF (ERA 2025) - "Among participants of FINEARTS-HF, despite relatively low levels of baseline albuminuria, early changes in UACR accounted for a modest proportion of the effect of finerenone on reducing cardiovascular outcomes."

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

Dapaglifozin and finerenone: real-world data on safety and efficacy in patients with diabetic chronic kidney disease (CKD). (ERA 2025) - "Background and Aims:DAPA-CKD study showed benefits in composite renal and cardiovascular outcomes with dapagliflozin compared to placebo in patients with and without diabetic CKD. In this report we showed the significant effects of combined therapy (dapaglifozin and finerenone) on reducing albuminuria in patients with diabetic CKD and proteinuria. This is expected to have effect on slowing the progression of the disease, but larger prospective studies are needed to show this."

Clinical • Real-world • Real-world evidence • Cardiovascular • Chronic Kidney Disease • Diabetes • Hypertension • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus

Finerenone as a Novel Non-Steroidal Mineralocorticoid Receptor Antagonist: A Potential Therapeutic Option for Lupus Nephritis (ERA 2025) - "This pilot trial demonstrates that Finerenone effectively reduces residual proteinuria in LN patients and offers additional renal protection when combined with standard therapies. Despite the small sample size, our findings suggest that Finerenone can be safely and effectively used in LN patients. We believe that the combination of Finerenone, RAAS inhibitors, and SGLT2 inhibitors may provide additive renal benefits in LN due to their complementary mechanisms, potentially enabling comprehensive 'lupus-cardio-kidney' co-management."

Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Diabetes • Diabetic Nephropathy • Fibrosis • Glomerulonephritis • Heart Failure • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Metabolic Disorders • Nephrology

A pregnancy reduces kidney lifespan in Col4a3-/- mice with Alport Nephropathy. Impact of a renoprotective triple combination therapy on maternal kidney outcomes. (ERA 2025) - " Female Col4a3-deficient mice with established Alport nephropathy were randomized into four groups: 1) vehicle only (nil), 2) late treatment starting at 6 weeks of age, 3) early treatment starting at 3 weeks of age, and 4) early treatment with one pregnancy, all with food admixtures of ramipril (10 mg/kg), empagliflozin (30 mg/kg), and finerenone (10 mg/kg). Our results show that early triple therapy of CKD can have a major impact on kidney survival and even allow a pregnancy in mice that would not survive a pregnancy without. However, the pregnancy itself significantly reduces the renoprotective effect of such a triple therapy, probably because a pregnancy accelerates the progressive demise of the kidneys by transiently increasing kidney workload despite reduced kidney capacity and despite renoprotective therapy. Another conclusion is that human stories with short-term analysis of surrogate markers that integrate compensatory hyperfiltration can be misleading."

Combination therapy • Preclinical • Chronic Kidney Disease • Gynecology • Nephrology • Renal Disease

Understanding cardiovascular benefits of finerenone: the role of central arterial stiffness (ERA 2025) - "Finerenone substantially decreased central arterial stiffness while preserving kidney function, volume status, and blood pressure. No clinically significant hyperkalemia was observed. Further research is needed to explore the endothelial effects of finerenone, which may provide insights into the observed reduction in central arterial stiffness."

Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Coronary Artery Disease • Dyslipidemia • Heart Failure • Nephrology • Pulmonary Arterial Hypertension • Renal Disease

Epidemiological Profile of Patients with Diabetic Kidney Disease and Heart Failure Initiating Finerenone: Insights from Real-World Data. (ERA 2025) - "Of these, 20.9% were MRA-naïve patients, while 79.1% were previously on an MRA; 38.7% were on spironolactone, and 40.4% were on eplerenone...Diuretics were used by 74.2%, predominantly furosemide (95.7%), with a mean dose of 30 mg, predominantly furosemide (95.7%), with a mean dose of 30 mg...Potassium binders were used by 29,1% of patients (12.9% calcium polystyrene sulfonate and 16,2% sodium zirconium cyclosilicate)... These findings provide a comprehensive profile of patients with HF and DKD initiating finerenone in a real-world cohort, highlighting the significant burden of comorbidities and the interplay between cardiac and renal dysfunction in this population. The clinical, laboratory, and treatment parameters data underscores the complexity of managing these high-risk patients in real-world settings. A longer follow-up is needed to know the finerenone impact in this population."

Clinical • Real-world • Real-world evidence • Cardiomyopathy • Cardiovascular • Chronic Kidney Disease • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Diabetic Nephropathy • Dyslipidemia • Heart Failure • Hypertension • Metabolic Disorders • Nephrology • Renal Disease • Type 2 Diabetes Mellitus