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Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes

Finerenone is a selective nonsteroidal mineralocorticoid receptor antagonist with a short half-life. Its effects on cardiorenal outcomes were thought to be mediated primarily via nonhemodynamic pathways, but office blood pressure (BP) measurements were insufficient to fully assess hemodynamic effect...

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Autores principales: Agarwal, Rajiv, Ruilope, Luis M., Ruiz-Hurtado, Gema, Haller, Hermann, Schmieder, Roland E., Anker, Stefan D., Filippatos, Gerasimos, Pitt, Bertram, Rossing, Peter, Lambelet, Marc, Nowack, Christina, Kolkhof, Peter, Joseph, Amer, Bakris, George L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799031/
https://www.ncbi.nlm.nih.gov/pubmed/36583355
http://dx.doi.org/10.1097/HJH.0000000000003330
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author Agarwal, Rajiv
Ruilope, Luis M.
Ruiz-Hurtado, Gema
Haller, Hermann
Schmieder, Roland E.
Anker, Stefan D.
Filippatos, Gerasimos
Pitt, Bertram
Rossing, Peter
Lambelet, Marc
Nowack, Christina
Kolkhof, Peter
Joseph, Amer
Bakris, George L
author_facet Agarwal, Rajiv
Ruilope, Luis M.
Ruiz-Hurtado, Gema
Haller, Hermann
Schmieder, Roland E.
Anker, Stefan D.
Filippatos, Gerasimos
Pitt, Bertram
Rossing, Peter
Lambelet, Marc
Nowack, Christina
Kolkhof, Peter
Joseph, Amer
Bakris, George L
author_sort Agarwal, Rajiv
collection PubMed
description Finerenone is a selective nonsteroidal mineralocorticoid receptor antagonist with a short half-life. Its effects on cardiorenal outcomes were thought to be mediated primarily via nonhemodynamic pathways, but office blood pressure (BP) measurements were insufficient to fully assess hemodynamic effects. This analysis assessed the effects of finerenone on 24-h ambulatory BP in patients with chronic kidney disease and type 2 diabetes. METHODS: ARTS-DN (NCT01874431) was a phase 2b trial that randomized 823 patients with type 2 diabetes and chronic kidney disease, with urine albumin-to-creatinine ratio ≥30 mg/g and estimated glomerular filtration rate of 30–90 ml/min per 1.73 m(2) to placebo or finerenone (1.25–20 mg once daily in the morning) administered over 90 days. Ambulatory BP monitoring (ABPM) over 24 h was performed in a subset of 240 patients at screening, Day 60, and Day 90. RESULTS: Placebo-adjusted change in 24-h ABPM systolic BP (SBP) at Day 90 was –8.3 mmHg (95% confidence interval [CI], –16.6 to 0.1) for finerenone 10 mg (n = 27), –11.2 mmHg (95% CI, –18.8 to –3.6) for finerenone 15 mg (n = 34), and –9.9 mmHg (95% CI, –17.7 to –2.0) for finerenone 20 mg (n = 31). Mean daytime and night-time SBP recordings were similarly reduced and finerenone did not increase the incidence of SBP dipping. Finerenone produced a persistent reduction in SBP over the entire 24-h interval. CONCLUSIONS: Finerenone reduced 24-h, daytime, and night-time SBP. Despite a short half-life, changes in BP were persistent over 24 h with once-daily dosing in the morning.
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spelling pubmed-97990312023-01-04 Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes Agarwal, Rajiv Ruilope, Luis M. Ruiz-Hurtado, Gema Haller, Hermann Schmieder, Roland E. Anker, Stefan D. Filippatos, Gerasimos Pitt, Bertram Rossing, Peter Lambelet, Marc Nowack, Christina Kolkhof, Peter Joseph, Amer Bakris, George L J Hypertens Original Articles Finerenone is a selective nonsteroidal mineralocorticoid receptor antagonist with a short half-life. Its effects on cardiorenal outcomes were thought to be mediated primarily via nonhemodynamic pathways, but office blood pressure (BP) measurements were insufficient to fully assess hemodynamic effects. This analysis assessed the effects of finerenone on 24-h ambulatory BP in patients with chronic kidney disease and type 2 diabetes. METHODS: ARTS-DN (NCT01874431) was a phase 2b trial that randomized 823 patients with type 2 diabetes and chronic kidney disease, with urine albumin-to-creatinine ratio ≥30 mg/g and estimated glomerular filtration rate of 30–90 ml/min per 1.73 m(2) to placebo or finerenone (1.25–20 mg once daily in the morning) administered over 90 days. Ambulatory BP monitoring (ABPM) over 24 h was performed in a subset of 240 patients at screening, Day 60, and Day 90. RESULTS: Placebo-adjusted change in 24-h ABPM systolic BP (SBP) at Day 90 was –8.3 mmHg (95% confidence interval [CI], –16.6 to 0.1) for finerenone 10 mg (n = 27), –11.2 mmHg (95% CI, –18.8 to –3.6) for finerenone 15 mg (n = 34), and –9.9 mmHg (95% CI, –17.7 to –2.0) for finerenone 20 mg (n = 31). Mean daytime and night-time SBP recordings were similarly reduced and finerenone did not increase the incidence of SBP dipping. Finerenone produced a persistent reduction in SBP over the entire 24-h interval. CONCLUSIONS: Finerenone reduced 24-h, daytime, and night-time SBP. Despite a short half-life, changes in BP were persistent over 24 h with once-daily dosing in the morning. Lippincott Williams & Wilkins 2023-02 2022-12-08 /pmc/articles/PMC9799031/ /pubmed/36583355 http://dx.doi.org/10.1097/HJH.0000000000003330 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Articles
Agarwal, Rajiv
Ruilope, Luis M.
Ruiz-Hurtado, Gema
Haller, Hermann
Schmieder, Roland E.
Anker, Stefan D.
Filippatos, Gerasimos
Pitt, Bertram
Rossing, Peter
Lambelet, Marc
Nowack, Christina
Kolkhof, Peter
Joseph, Amer
Bakris, George L
Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title_full Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title_fullStr Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title_full_unstemmed Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title_short Effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
title_sort effect of finerenone on ambulatory blood pressure in chronic kidney disease in type 2 diabetes
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9799031/
https://www.ncbi.nlm.nih.gov/pubmed/36583355
http://dx.doi.org/10.1097/HJH.0000000000003330
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