Finerenone effects on biomarkers: an analysis from the FIGARO-DKD trial

作者：Mario Berger, Aidan MacNamara, João Pedro Ferreira, Peter Kolkhof, Sebastian Voß, Adam Skubala, Andrea Scalise, Laura Goea, Richard Nkulikiyinka, Bertram Pitt, Joachim Hanno, Peter Rossing, Richard J. Coward, Faı̈ez Zannad, Hiddo J.L. Heerspink · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf316 · 被引用次数：14 · 研究领域：Hormonal Regulation and Hypertension、Pituitary Gland Disorders and Treatments、Adrenal Hormones and Disorders

Finerenone is a non-steroidal mineralocorticoid receptor antagonist (MRA) selective for the MR.1 In three large outcome trials, finerenone improved cardiovascular (CV) and kidney outcomes in patients with chronic kidney disease (CKD) and Type 2 diabetes (T2D), and reduced the risk for the composite endpoint of total heart failure events and CV death in heart failure patients with ejection fraction ≥40.2–4 In animal models of cardiorenal disease, finerenone treatment ameliorated cardiac and renal hypertrophy, reduced sodium retention and proteinuria. Along with histological findings of structural improvement in heart and kidneys, several inflammation and fibrosis-associated biomarkers were reduced by finerenone.1 Less is known about the proteomic profile of finerenone in humans. Hence, this study describes the longitudinal effects of finerenone on the plasma proteome in patients with CKD and T2D. This is a post hoc analysis of the biomarker sub-study to the Phase III trial, FIGARO-DKD.3 It included 929 subjects from 115 clinical sites in 21 countries; site selection was based on above-average recruitment. 2941 biomarkers were measured in a total of 4193 samples on Olink Explore3072. All participants had been on treatment with either placebo or finerenone for ≥24 months and samples from the first post-randomization visit (month 4[M4]), up to month 48 after treatment initiation were analysed. Baseline samples were not available. Finerenone effects were assessed using linear mixe...