The following is a summary of “Impact of Finerenone on Cardiac Biomarkers in Patients With T2D and Chronic Kidney Disease,” published in the November 2023 issue of Cardiology by Berger et al.
Finerenone, a selective MR antagonist, tackles excess sodium retention and harmful mineralocorticoid receptor (MR) overactivity in T2D and CKD.
Researchers conducted a prospective study to investigate biomarkers from FIGARO-DKD and FIDELIO-DKD trials, analyzing NT-proBNP and cardiac troponin T (cTnT) levels to unlock the cardiac effects of finerenone in T2D and CKD.
They collected samples from consenting, non-selected patients at BL, 1,037 subjects with cTnT data, and 1,592 subjects with NT-proBNP data from 13 and 24 countries, respectively. Samples were analyzed at baseline and throughout 4-48 months of finerenone or PL treatment. Biomarker treatment effects were computed using a model adjusting for age, gender, eGFR, UACR, CVD history, BL biomarker levels, and geographical region.
The results showed an increase in both NT-proBNP and cTnT over time in both arms. However, the active arm demonstrated a significantly lower rise than PLC despite the transient reduction in eGFR caused by finerenone. At month 4, the maximum ratio (finerenone to PLC) was 0.82 (95% CI: 0.76 to 0.90) for NT-proBNP, and at month 36, it was 0.94 (95% CI: 0.892 to 0.995) for cTnT. Median biomarker levels at baseline stood at 177 pg/mL (NT-proBNP, IQR: 74-426) and 18 pg/mL (cTnI, IQR: 7-27).
Investigators concluded that finerenone eased cardiac stress in T2D/CKD, hinting at how it improved outcomes in FIDELITY.
Source: ahajournals.org/doi/10.1161/circ.148.suppl_1.13298
