The effect of Finerenone on blood pressure and heart rate in hospitalized diabetic patients.

What is it about?

The long-term cardiorenal benefits of finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), have been established in large RCTs and post hoc analyses, such as FIDELIO, FIGARO, and FIDELITY, as well as subsequent clinical trials. However, in a real-world clinical setting, the administration of finerenone in DKD patients is often complicated by hypertension and drug history. Thus, what is the short-term effect on BP and HR after adding finerenone in these patients? This study examined the trend and time to effect of finerenone in DKD patients, analyzed at different time points during regular admission days.

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Photo by CDC on Unsplash

Photo by CDC on Unsplash

Why is it important?

MRA, by binding to and blocking critical components and final receptors of RAAS, could not only reverse the "aldosterone escape" observed with traditional ARB and ACEI treatment, thereby modulating hemodynamics, but also, through long-term gene effects, block downstream inflammation and fibrosis in both the heart and kidney. These outcomes have been proclaimed and demonstrated in previous large RCTs and clinical trials. It could postpone and lessen proteinuria and CKD and HF progression; however, in real-world settings, DKD patients were often multi-drug recipients. Thus, it is unclear what the acute hemodynamic effect is when Finerenone, a novel MRA, is administered to these hospitalized patients. It also assesses whether this treatment is associated with long-term improvements in RAAS and metabolic status. Therefore, this study examined the addition of finerenone at different time points during regular hospitalization. It will assess hemodynamic trends, time to effect, potential treatment value, safety, and efficacy when combined with other antihypertensive medications in DKD with different progression stages.

Perspectives