Review
Urology & Nephrology
Panagiotis I. Georgianos, Rajiv Agarwal
Summary: The article discusses the detrimental effects of MR overactivation in CKD models on the heart, kidney, and blood vessels, as well as the potential of Finerenone as a novel MR antagonist to improve the progression of cardiorenal disease.
KIDNEY INTERNATIONAL REPORTS
(2021)
Review
Endocrinology & Metabolism
Gianluigi Savarese, Felix Lindberg, Gerasimos Filippatos, Javed Butler, Stefan D. Anker
Summary: The overactivation of mineralocorticoid receptors affects multiple physiological systems, and the use of classical MR antagonists has shown improvements in heart failure. However, concerns about side effects and limited tolerability have hindered their implementation in other settings. Non-steroidal MR antagonists have shown potential benefits and better safety profiles. This review provides an overview of the impact of MR overactivation and discusses the potential of non-steroidal MR antagonists.
Article
Biochemistry & Molecular Biology
Sofia S. Pereira, Liliana Carvalho, Madalena M. Costa, Armindo Melo, Isabel M. P. L. V. O. Ferreira, Celso E. Gomez-Sanchez, Mariana P. Monteiro, Gavin Vinson, Duarte Pignatelli
Summary: The study evaluated the effects of MRAs on adrenal cortical physiology and morphology, showing that MRA treatment may lead to aldosterone-secreting cell proliferation and higher circulating aldosterone levels, resulting in alterations in adrenal gland function and morphology.
Review
Chemistry, Medicinal
Nina Vodosek Hojs, Sebastjan Bevc, Robert Ekart, Nejc Piko, Tadej Petreski, Radovan Hojs
Summary: Diabetes and chronic kidney disease are global health issues with a strong connection, as diabetic kidney disease affects a significant portion of diabetic patients. Non-steroidal mineralocorticoid receptor antagonists (MRA) have shown promise in treating DKD with fewer side effects compared to steroidal MRAs. Research in this area continues to expand to optimize treatment options.
Review
Pharmacology & Pharmacy
Zachary M. Howard, Chetan K. Gomatam, Arden B. Piepho, Jill A. Rafael-Fortney
Summary: Duchenne muscular dystrophy (DMD) is a muscle degenerative disease caused by the loss of dystrophin protein. Current standard-of-care treatment for DMD has limited efficacy and serious side effects. Mineralocorticoid receptor antagonists (MRAs) have shown promise as a therapeutic target for DMD, as they can improve muscle function and reduce inflammation and fibrosis.
FRONTIERS IN PHARMACOLOGY
(2022)
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Bertram Pitt, Rajiv Agarwal, Dimitrios Farmakis, Luis M. Ruilope, Peter Rossing, Johann Bauersachs, Robert J. Mentz, Peter Kolkhof, Charlie Scott, Amer Joseph, George L. Bakris, Stefan D. Anker
Summary: In the FIDELIO-DKD trial, finerenone improved cardiorenal outcomes in patients with CKD and T2D regardless of history of heart failure.
EUROPEAN JOURNAL OF HEART FAILURE
(2022)
Review
Urology & Nephrology
Pantelis Sarafidis, Fotini Iatridi, Charles Ferro, Maria-Eleni Alexandrou, Beatriz Fernandez-Fernandez, Mehmet Kanbay, Francesca Mallamaci, Ionut Nistor, Patrick Rossignol, Christoph Wanner, Mario Cozzolino, Alberto Ortiz, ERBP Board
Summary: Chronic kidney disease (CKD) in individuals with type 2 diabetes is a major public health issue. Renin-angiotensin system (RAS) blockers have been the standard treatment, but their effectiveness in reducing cardiovascular events and mortality is limited. Non-steroidal mineralocorticoid receptor antagonists (MRAs) have gained interest due to their better pharmacologic profile. Finerenone, the first compound of this class, has shown promise in reducing kidney disease progression and cardiovascular outcomes in patients with type 2 diabetes.
CLINICAL KIDNEY JOURNAL
(2023)
Review
Endocrinology & Metabolism
Morag J. Young, Monica Kanki, Nikshay Karthigan, Penny Konstandopoulos
Summary: Mineralocorticoid receptor (MR) antagonists, also known as aldosterone blockers, have shown clinical benefits in treating patients with heart failure, including those with reduced ejection fraction and preserved ejection fraction with reduced left ventricular filling. The MR has various physiological and pathophysiological roles in the heart, vasculature, and other tissues, which underpin the use of MR antagonists in cardiovascular disease, particularly heart failure. The development of MR antagonists has progressed from potassium-sparing diuretics to more receptor-selective options, demonstrating the evolution of treatment options for cardiovascular diseases.
Review
Endocrinology & Metabolism
Morag J. Young, Monica Kanki, Nikshay Karthigan, Penny Konstandopoulos
Summary: Mineralocorticoid receptor antagonists, also known as aldosterone blockers, have been widely recognized for their clinical benefits in treating heart failure, improving outcomes for both HFrEF and HFpEF patients. As research continues to evolve, new nonsteroidal receptor antagonists like esaxerenone and finerenone have emerged, showcasing the constantly evolving landscape of cardiovascular disease treatment.
Review
Peripheral Vascular Disease
Atsuhisa Sato, Mitsuhiro Nishimoto
Summary: This article summarizes the latest evidence on the use of nonsteroidal MR antagonists in the treatment of diabetic kidney disease (DKD). It highlights the effectiveness of MR antagonists and suggests measures for managing hyperkalemia. The study emphasizes the importance of continuous use of MR antagonists in DKD treatment.
HYPERTENSION RESEARCH
(2022)
Review
Behavioral Sciences
Claire L. Pince, Kimberly E. Whiting, Tammy Wang, Andras H. Leko, Lisa A. Farinelli, Diane Cooper, Mehdi Farokhnia, Leandro F. Vendruscolo, Lorenzo Leggio
Summary: This scoping review summarizes the role of aldosterone and mineralocorticoid receptor (MR) in addiction and the potential effects of pharmacological manipulations of MR on addiction-related outcomes. The findings suggest that dysregulations of aldosterone and MR occur in both peripheral and central systems and are influenced by drug exposure patterns and genetic factors. Antagonism of MR holds promise as a potential target for the treatment of addiction, but further research is needed.
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
(2023)
Article
Peripheral Vascular Disease
Ryo Nakamaru, Koichi Yamamoto, Hiroshi Akasaka, Hiromi Rakugi, Isao Kurihara, Takashi Yoneda, Takamasa Ichijo, Takuyuki Katabami, Mika Tsuiki, Norio Wada, Tetsuya Yamada, Hiroki Kobayashi, Kouichi Tamura, Yoshihiro Ogawa, Junji Kawashima, Nobuya Inagaki, Megumi Fujita, Kenji Oki, Kohei Kamemura, Akiyo Tanabe, Mitsuhide Naruse
Summary: The study found that female patients with bilateral primary aldosteronism have worse renal outcomes compared to male patients after receiving mineralocorticoid receptor antagonist treatment. Despite similar systolic blood pressure levels between the sexes, women experienced a greater decline in estimated glomerular filtration rate, especially during the late phase of 6 to 60 months post-treatment initiation.
Article
Pharmacology & Pharmacy
Bertram Pitt, Frederic Jaisser, George Bakris
Summary: This study reviews the current challenges in treating RH in CKD patients and the potential application of a novel nonsteroidal MRA (KBP-5074) in this area.
EXPERT OPINION ON INVESTIGATIONAL DRUGS
(2021)
Review
Endocrinology & Metabolism
Nikshay Karthigan, Siobhan Lockwood, Anthony White, Jun Yang, Morag J. Young
Summary: The mineralocorticoid receptor plays an important role in heart failure, but its treatment benefit is unclear for patients with preserved ejection fraction. Currently, there are no biomarkers available to predict treatment response, but finding such biomarkers is crucial for improving treatment efficacy and avoiding unnecessary side effects.
JOURNAL OF ENDOCRINOLOGY
(2022)
Article
Pharmacology & Pharmacy
Katrin Fasler, Jeanne M. Gunzinger, Daniel Barthelmes, Sandrine A. Zweifel
Summary: This study compared the efficacy of eplerenone therapy versus observation on resolution of subretinal fluid in patients with acute and chronic CSCR. The results showed a decrease in SRF in both groups at 12 months, indicating no significant difference in SRF resolution between treated and observed eyes.
FRONTIERS IN PHARMACOLOGY
(2021)