Efficacy and safety of finerenone in chronic kidney disease and type 2 diabetes patients: a systematic review and meta-analysis

医学 肾脏疾病 糖尿病 肾功能 内科学 2型糖尿病 随机对照试验 荟萃分析 心力衰竭 入射(几何) 重症监护医学 内分泌学 光学 物理
作者
Farah Yasmin,Muhammad Aamir,Hala Najeeb,Abdul Raafe Atif,Abdul Hannan Siddiqui,Muhammad Ahsan,Abdul Moeed,Syed Hasan Ali,Haya Muhammad Tahir,Muhammad Sohaib Asghar
出处
期刊:Annals of medicine and surgery [Wolters Kluwer]
卷期号:85 (10): 4973-4980 被引量:1
标识
DOI:10.1097/ms9.0000000000001180
摘要

The incidence of morbidity and mortality in patients with type 2 diabetes mellitus is substantially correlated with cardiovascular disease and chronic kidney disease. The current guidelines recommend the use of renin-angiotensin system blockers, but recent studies probed into the effects of finerenone to mitigate the risk of cardiorenal events. This meta-analysis was performed to demonstrate the effects of finerenone on cardiorenal events, comprising cardiovascular mortality, heart failure, change in estimated glomerular filtration rate, and serum potassium levels.After screening with our eligibility criteria, 350 articles were identified with an initial literature search on multiple databases, including PubMed, Science Direct, and Cochrane Central. Seven randomized controlled trials with a total of 15 462 patients (n=8487 in the finerenone group; n=6975 in the control group) were included.Patients receiving finerenone were at a reduced risk for cardiovascular mortality [HR: 0.84 (0.74, 0.95)], heart failure [OR: 0.79 (0.68, 0.92)], decrease in estimated glomerular filtration rate by 40% [OR: 0.82 (0.74, 0.91)] and by 57% [OR: 0.70 (0.59, 0.82)]; and a higher incidence of moderate hyperkalemia [OR: 2.25 (1.78, 2.84)].Finerenone, owing to its better mineralocorticoid affinity, and a much lower risk of adverse effects, promises to be a much better alternative than other renin-angiotensin system blockers available for the treatment of chronic kidney disease patients with type 2 diabetes. Further trials should be conducted to provide more definitive evidence to assess the safety and efficacy of finerenone compared to spironolactone and eplerenone.
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