Review
Endocrinology & Metabolism
Ralph A. DeFronzo, George L. Bakris
Summary: Chronic kidney disease (CKD) is the most common cause of kidney failure in patients with type 2 diabetes and is a major contributor to the global burden of disease. However, current treatment options have limited effectiveness in slowing CKD progression and reducing cardiovascular events. Recent studies have shown that finerenone, a non-steroidal mineralocorticoid receptor antagonist, is an effective treatment for slowing CKD progression and providing cardiovascular protection in patients with type 2 diabetes.
DIABETES OBESITY & METABOLISM
(2022)
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Stefan D. Anker, Rajiv Agarwal, Luis M. Ruilope, Peter Rossing, George L. Bakris, Christoph Tasto, Amer Joseph, Peter Kolkhof, Andrea Lage, Bertram Pitt
Summary: Finerenone reduces the incidence of new-onset HF and improves other HF outcomes in patients with chronic kidney disease and type 2 diabetes, regardless of a history of HF.
Article
Transplantation
Rajiv Agarwal, Stefan D. Anker, George Bakris, Gerasimos Filippatos, Bertram Pitt, Peter Rossing, Luis Ruilope, Martin Gebel, Peter Kolkhof, Christina Nowack, Amer Joseph
Summary: Research has found that finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, can protect the kidneys and hearts of patients with chronic kidney disease and type 2 diabetes. The FIDELIO-DKD and FIGARO-DKD trials are investigating the efficacy and safety of finerenone on kidney failure and cardiovascular outcomes in T2D patients with different stages of kidney disease.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2022)
Article
Peripheral Vascular Disease
Luis M. Ruilope, Rajiv Agarwal, Stefan D. Anker, Gerasimos Filippatos, Bertram Pitt, Peter Rossing, Pantelis Sarafidis, Roland E. Schmieder, Amer Joseph, Nicole Rethemeier, Christina Nowack, George L. Bakris
Summary: This analysis explored the relationship between office systolic blood pressure (SBP) and cardiorenal outcomes with finerenone in FIDELIO-DKD trial. Finerenone significantly reduced office SBP across all baseline SBP quartiles and improved cardiorenal outcomes. Reductions in office SBP accounted for a small proportion of the treatment effect on cardiorenal outcomes.
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Stefan D. Anker, Bertram Pitt, Darren K. McGuire, Peter Rossing, Luis M. Ruilope, Javed Butler, Ewa A. Jankowska, Erin D. Michos, Dimitrios Farmakis, Alfredo E. Farjat, Peter Kolkhof, Andrea Scalise, Amer Joseph, George L. Bakris, Rajiv Agarwal
Summary: Finerenone consistently reduces the risk of cardiovascular and kidney outcomes in patients with type 2 diabetes and chronic kidney disease, regardless of their history of atherosclerotic cardiovascular disease.
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
(2022)
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Stefan D. Anker, Bertram Pitt, Peter Rossing, Amer Joseph, Peter Kolkhof, Marc Lambelet, Robert Lawatscheck, George L. Bakris, Luis M. Ruilope, Rajiv Agarwal
Summary: This study found that finerenone can improve HF-related outcomes in patients with CKD and T2D, regardless of baseline eGFR and/or UACR categories.
JACC-HEART FAILURE
(2022)
Article
Endocrinology & Metabolism
Peter Rossing, Rajiv Agarwal, Stefan D. Anker, Gerasimos Filippatos, Bertram Pitt, Luis M. Ruilope, Aslam Amod, Michel Marre, Amer Joseph, Andrea Lage, Charlie Scott, George L. Bakris
Summary: The study showed that finerenone significantly reduced the risk of kidney and cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes. There was no clear interaction between GLP-1RA use and the treatment effect of finerenone, indicating consistent effects on kidney and cardiovascular outcomes regardless of GLP-1RA use.
DIABETES OBESITY & METABOLISM
(2022)
Review
Medicine, General & Internal
Monarch Shah, Alaa S. Awad, Emaad M. Abdel-Rahman
Summary: Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, shows promising therapeutic effects in heart failure and chronic kidney disease. Clinical trials demonstrate its efficacy in improving kidney and cardiovascular outcomes, particularly in patients with CKD and T2DM.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Cardiac & Cardiovascular Systems
Gerasimos Filippatos, Stefan D. Anker, Rajiv Agarwal, Bertram Pitt, Luis M. Ruilope, Peter Rossing, Peter Kolkhof, Patrick Schloemer, Ingo Tornus, Amer Joseph, George L. Bakris
Summary: The FIDELIO-DKD trial demonstrated that Finerenone reduced the incidence of cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes, with a composite outcome including cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure. There was no difference in the treatment effect based on preexisting cardiovascular disease status, with similar incidence of adverse events between treatment arms.
Review
Endocrinology & Metabolism
Cheng-Hsuan Tsai, Ya-Li Chen, Chien-Ting Pan, Yen-Tin Lin, Po-Chin Lee, Yu-Wei Chiu, Che-Wei Liao, Zheng-Wei Chen, Chin-Chen Chang, Yi-Yao Chang, Chi-Sheng Hung, Yen-Hung Lin
Summary: The meta-analysis results showed that compared to PA patients receiving adrenalectomy and patients with essential hypertension, PA patients receiving MRA treatment had a higher risk of NOAF.
FRONTIERS IN ENDOCRINOLOGY
(2021)
Article
Urology & Nephrology
Katja Luettges, Marlies Bode, Jan Niklas Diemer, Juliane Schwanbeck, Eva K. Wirth, Robert Klopfleisch, Kai Kappert, Arne Thiele, Daniel Ritter, Anna Foryst-Ludwig, Peter Kolkhof, Ulrich Otto Wenzel, Ulrich Kintscher
Summary: This study investigated the anti-inflammatory/fibrotic and immunological effects of the nonsteroidal MR antagonist finerenone in a cardiorenal disease model. The results showed that finerenone could alleviate cardiorenal damage, reduce blood pressure, decrease renal inflammatory cell content, and improve cardiac function.
AMERICAN JOURNAL OF NEPHROLOGY
(2022)
Review
Urology & Nephrology
Rajesh Raj
Summary: Recent clinical trials suggest that the mineralocorticoid receptor antagonist finerenone improves outcomes in patients with diabetic kidney disease. These trials show that finerenone provides modest further improvement in composite renal and cardiovascular outcomes in proteinuric patients with DKD who are already on renin-angiotensin-aldosterone system inhibitors. However, hyperkalaemia remains a concern, although newer potassium binding agents may help mitigate this risk. Emerging data also suggest additive benefits when finerenone and sodium-glucose co-transporter 2 inhibitors are used in combination. The benefits of finerenone in chronic kidney disease without diabetes are still uncertain.
CURRENT OPINION IN NEPHROLOGY AND HYPERTENSION
(2022)
Article
Pharmacology & Pharmacy
Edgar V. Lerma, Daniel J. Wilson
Summary: This review introduces Finerenone as a new treatment for CKD associated with T2D. Compared to traditional treatments, Finerenone offers a better benefit-risk profile and reduces the occurrence of kidney- and CV-related endpoints. Increases in serum potassium are predictable and manageable and should not discourage clinical application.
EXPERT REVIEW OF CLINICAL 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
Cardiac & Cardiovascular Systems
Francesco Piccirillo, Paola Liporace, Annunziata Nusca, Vincenzo Nafisio, Andrea Corliano, Francesca Magaro, Raffaele Antonelli Incalzi, Gian Paolo Ussia, Francesco Grigioni
Summary: Patients with CVD and CKD have high rates of cardiorenal outcomes. Activation of the MR induces cardiac and renal injury, and finerenone has shown anti-inflammatory and anti-fibrotic effects in pre-clinical studies. Two large trials investigated the outcomes of finerenone in patients with CKD and type 2 diabetes.
JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
(2023)
Article
Transplantation
Jennifer B. Green, Amy K. Mottl, George Bakris, Hiddo J. L. Heerspink, Johannes F. E. Mann, Janet B. McGill, Masaomi Nangaku, Peter Rossing, Charlie Scott, Alain Gay, Rajiv Agarwal
Summary: This study aims to investigate the efficacy of dual therapy with finerenone and an SGLT2i in reducing chronic kidney disease and type 2 diabetes. The results will provide important insights for improving treatment methods for kidney disease and cardiovascular risks.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2023)
Article
Transplantation
Rong M. Zhang, Frederik Persson, Janet B. McGill, Peter Rossing
Summary: Chronic kidney disease (CKD) associated with type 2 diabetes (T2D) is a serious complication with high morbidity and mortality. Current guidelines recommend annual screening for CKD, blood pressure and glucose control, as well as the use of renin-angiotensin system (RAS) inhibition. Recent additions to the guidelines include the use of SGLT2 inhibitors and finerenone, based on robust clinical trial data, to improve CKD outcomes in T2D patients.
NEPHROLOGY DIALYSIS TRANSPLANTATION
(2023)
Article
Urology & Nephrology
Rajiv Agarwal, Bertram Pitt, Biff F. Palmer, Csaba P. Kovesdy, Ellen Burgess, Gerasimos Filippatos, Jolanta Malyszko, Luis M. Ruilope, Patrick Rossignol, Peter Rossing, Roberto Pecoits-Filho, Stefan D. Anker, Amer Joseph, Robert Lawatscheck, Daniel Wilson, Martin Gebel, George L. Bakris
Summary: This study compared the differences in blood pressure reduction and hyperkalemia risk between nonsteroidal MRA finerenone and steroidal MRA spironolactone +/- a potassium binder in patients with treatment-resistant hypertension and chronic kidney disease. The results showed that finerenone had a lower reduction in blood pressure and lower risk of hyperkalemia and treatment discontinuation compared to spironolactone with or without patiromer.
CLINICAL KIDNEY JOURNAL
(2023)
Article
Endocrinology & Metabolism
Niels H. Brandt-Jacobsen, Mikkel Jurgens, Philip Hasbak, Peter Gaede, Peter Rossing, Jon J. Rasmussen, Camillla Fuchs Andersen, Julie L. Forman, Jens Faber, Silvio E. Inzucchi, Finn Gustafsson, Morten Schou, Caroline Kistorp
Summary: This study investigated the effects of short-term empagliflozin therapy on cardiac adipose tissue accumulation in patients with type 2 diabetes. The results showed that empagliflozin can reduce cardiac adipose tissue accumulation and improve weight and glucose metabolism. However, no correlation was observed between changes in cardiac volumetrics and cardiac adipose tissue accumulation.
DIABETES OBESITY & METABOLISM
(2023)
Article
Cardiac & Cardiovascular Systems
Christopher R. Defilippi, Wendimagegn G. Alemayehu, Adriaan A. Voors, David Kaye, Robert O. Blaustein, Javed Butler, Justin A. Ezekowitz, Adrian F. Hernandez, Carolyn S. P. Lam, Lothar Roessig, Stephen Seliger, Palak Shah, Cynthia M. Westerhout, Paul W. Armstrong, Christopher M. O'connor, Victoria Study Grp
Summary: In the VICTORIA trial, biomarkers including hs-cTnT, GDF-15, and IL-6 were found to be associated with prognosis in heart failure patients, and lower levels of hs-cTnT were linked to reduced cardiovascular death after vericiguat treatment.
JOURNAL OF CARDIAC FAILURE
(2023)
Article
Cardiac & Cardiovascular Systems
Burkert Pieske, Elisabeth Pieske-Kraigher, Carolyn S. P. Lam, Vojtech Melenovsky, Karen Sliwa, Yuri Lopatin, Juan Luis Arango, M. Cecilia M. Bahit, Christopher M. J. O'Connor, Mahesh J. Patel, Lothar A. Roessig, Daniel A. Morris, Martin M. Kropf, Cynthia M. Westerhout, Yinggan W. Zheng, Paul W. Armstrong
Summary: In patients with HF, Vericiguat treatment for 8 months improved left ventricular structure and function. However, the degree of improvement was not significantly different compared to the placebo group.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Biochemistry & Molecular Biology
Emil List Larsen, Andreas Andersen, Laura K. Kjaer, Mie K. Eickhoff, Marie Frimodt-Moller, Frederik Persson, Peter Rossing, Jens Lykkesfeldt, Filip K. Knop, Tina Vilsboll, Jorgen Rungby, Henrik E. Poulsen
Summary: Animal studies have shown that SGLT2 inhibition decreases oxidative stress, which may explain the cardiovascular protective effects observed following SGLT2 inhibition treatment. This study investigated the effects of two and twelve weeks of SGLT2 inhibition on DNA and RNA oxidation, and found that longer-term dapagliflozin treatment decreased DNA oxidation.
FREE RADICAL RESEARCH
(2023)
Article
Multidisciplinary Sciences
Christina Gjerlev W. Poulsen, Daniel G. K. Rasmussen, Federica Genovese, Tine Hansen, Signe Holm K. Nielsen, Henrik Reinhard, Bernt Johan von Scholten, Peter Jacobsen, Hans-Henrik Parving, Morten Asser Karsdal, Peter Rossing, Marie Frimodt-Moller
Summary: This study investigated whether C3M, a degradation product of collagen type III, is a risk marker for the progression of chronic kidney disease (CKD) in individuals with type 2 diabetes and microalbuminuria. The results showed that higher levels of sC3M were associated with CKD progression in these patients.
Article
Urology & Nephrology
Karina Haar Jensen, Frederik Persson, Ditte Hansen, Iain Bressendorff, Marie Moller, Peter Rossing, Eva Gravesen, Vanja Kosjerina, Dorte Vistisen, Rikke Borg
Summary: The PRIMETIME 1 study is a large Danish national study that aims to classify kidney disease in diabetes based on registry data. It provides a unique opportunity for future research in diabetic kidney disease.
CLINICAL KIDNEY JOURNAL
(2023)
Article
Endocrinology & Metabolism
Suvanjaa Sivalingam, Victor Soendergaard Wasehuus, Viktor Rotbain Curovic, Martin Baek Blond, Tine W. Hansen, Frederik Persson, Peter Rossing
Summary: The combination of semaglutide and empagliflozin did not lead to changes in UACR, GFR, blood pressure, body weight, or plasma renin levels in individuals with T2D and albuminuria. However, semaglutide improved glycaemic control and plasma aldosterone levels compared to placebo.
DIABETES OBESITY & METABOLISM
(2023)
Article
Cardiac & Cardiovascular Systems
Kieran F. Docherty, Carolyn S. P. Lam, Amina Rakisheva, Andrew J. S. Coats, Trisha Greenhalgh, Marco Metra, Mark C. Petrie, Giuseppe M. C. Rosano
Summary: A significant number of patients with heart failure face delays in diagnosis due to the non-specific symptoms. Diagnostic tools like measurement of natriuretic peptide concentrations are crucial but often underutilized. This clinical consensus statement aims to provide a diagnostic framework for non-cardiology physicians in the community to recognize and investigate patients with possible heart failure.
EUROPEAN JOURNAL OF HEART FAILURE
(2023)
Article
Biochemistry & Molecular Biology
Alexandra Louise Moller, Ninna Hahn Tougaard, Daniel Guldager Kring Rasmussen, Federica Genovese, Pernille Falberg Ronn, Tine Willum Hansen, Morten Asser Karsdal, Peter Rossing
Summary: The pro-fibrotic molecule endotrophin, generated during collagen type VI formation, has been identified as a potential risk marker for complications in type 1 diabetes. Higher levels of serum endotrophin were associated with kidney complications and increased mortality in type 1 diabetes patients. However, there was no significant association between serum endotrophin and cardiovascular events or diabetic eye disease. Urinary endotrophin was not found to be associated with any outcomes.
FRONTIERS IN MOLECULAR BIOSCIENCES
(2023)
Meeting Abstract
Cardiac & Cardiovascular Systems
Cynthia M. Westerhout, Yinggan Zheng, Lars Lund, Javed Butler, Richard W. Troughton, Michele Emdin, Carolyn S. P. Lam, Piotr Ponikowski, Robert Blaustein, Christopher M. O'Connor, Lothar Roessig, Adriaan Voors, Justin A. Ezekowitz, Paul Wayne Armstrong
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
(2023)
Article
Urology & Nephrology
Katja Vu Bartholdy, Niklas Dyrby Johansen, Nino Landler, Kristoffer Grundtvig Skaarup, Jesper Jensen, Iain Bressendorff, Morten Schou, Jacob Christensen, Bo Feldt-Rasmussen, Muthiah Vaduganathan, Scott Solomon, Richard Haynes, Frederik Persson, Peter Rossing, Lars Kober, Faiez Zannad, Ditte Hansen, Tor Biering-Sorensen
Summary: This study aims to evaluate the effects of SGLT2 inhibitors on cardiac structure and function in patients with CKD. The results will provide insights into the cardioprotective mechanisms of SGLT2 inhibitors in patients with CKD.
Article
Urology & Nephrology
Therese Adrian, Mads Hornum, Filip Krag Knop, Thomas Almdal, Peter Rossing, Lisa Lida, Niels Sondergaard Heinrich, Vincent Oltman Boer, Anouk Marsman, Esben Thade Petersen, Hartwig Roman Siebner, Bo Feldt-Rasmussen
Summary: This study investigated the prevalence of NAFLD in patients with type 2 diabetes and compared the difference between patients with and without CKD. The results showed that the incidence of NAFLD was similar among patients with type 2 diabetes, and there was no significant association with CKD (stages 3-5).