The drug finerenone significantly slows the decline in kidney function in patients with chronic kidney disease (CKD) who do not have diabetes.
This is shown by an international study led by clinical pharmacologist Hiddo Lambers Heerspink of the University Medical Center Groningen. This suggests that, for the first time, the drug is also effective in a large group of kidney patients who previously had fewer treatment options. The study results were published today in the New England Journal of Medicine.
The so-called FIND-CKD study followed 1,584 adults with chronic kidney disease for an average of just over three years. All participants had reduced kidney function and increased protein excretion in the urine, a major risk factor for further kidney damage. Half received finerenone daily, while the other half received a placebo in addition to standard treatment with ACE inhibitors or angiotensin receptor blockers.
Kidney function declines less
The primary outcome measure was the change in kidney function during the 2.5-year follow-up period. Kidney function is measured by the rate at which the kidneys filter blood, known as the eGFR value. In patients taking finerenone, the decline in eGFR was statistically significantly smaller than in the placebo group. According to Lambers Heerspink, the difference is also clinically relevant.
Lower risk of cardiovascular disease
In addition, finerenone was found to reduce the risk of serious kidney problems, hospitalization for heart failure, or death from cardiovascular disease. Lambers Heerspink: "In the finerenone group, 13.9 percent experienced such a complication, compared to 16.9 percent in the placebo group. That amounts to a reduction in risk of approximately 23 percent."
Less protein in urine
The amount of protein in the urine also decreased in finerenone users after six months. Lambers Heerspink: "The presence of protein in the urine is often an important and early sign of kidney damage. In the finerenone group, it decreased by an average of over 41 percent, compared to about 9 percent in the placebo group. More than half of the patients who received finerenone achieved a reduction of at least 30 percent in the amount of protein in their urine. Such a reduction is an important indicator of a more favorable renal prognosis."
Effective in kidney patients without diabetes
According to Lambers Heerspink, the results are striking because previous large studies with finerenone focused primarily on patients with type 2 diabetes. 'Now it turns out the drug is also effective in people without diabetes, even though more than half of all CKD patients worldwide are non-diabetic. Chronic kidney disease now affects an estimated 800 million adults worldwide."
New treatment option
The drug was also found to be safe to use. Lambers Heerspink: "Finerenone could become an important new treatment option for people with chronic kidney disease who do not have diabetes. The drug offers a clear delay in the decline of kidney function on top of current standard care. The results provide physicians with new therapeutic options to help preserve kidney function and reduce the number of cardiovascular and renal complications. And this applies to a broad, underserved patient population with non-diabetic CKD, for whom there are few treatment options in the guidelines."
