Finerenone reduces SBP in diabetic patients with CKD

Treatment with finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist with a short half-life, results in decreased 24-h, daytime, and night-time systolic blood pressure (SBP), results of a study have shown.

A team of investigators conducted a phase IIb trial that randomly assigned a total of 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 m², to receive placebo or finerenone (1.25‒20 mg once daily in the morning) administered over 90 days.

In a subset of 240 patients, the investigators performed ambulatory BP monitoring (ABPM) over 24 h at screening, day 60, and day 90.

At day 90, the placebo-adjusted change in 24-h ABPM SBP was ‒8.3 mm Hg (95 percent confidence interval [CI], ‒16.6 to 0.1) for finerenone 10 mg (n=27), ‒11.2 mm Hg (95 percent CI, ‒18.8 to ‒3.6) for finerenone 15 mg (n=34), and ‒9.9 mm Hg (95 percent CI, ‒17.7 to ‒2.0) for finerenone 20 mg (n=31).

Likewise, mean daytime and night-time SBP decreased. Finerenone also did not increase the incidence of SBP dipping. In addition, the study drug delivered a continuing decrease in SBP over the entire 24-h interval.

“Despite a short half-life, changes in BP were persistent over 24 h with once-daily dosing in the morning,” the investigators said.