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

被引:55
作者
Agarwal, Rajiv [1 ,2 ]
Ruilope, Luis M. [3 ,4 ,5 ]
Ruiz-Hurtado, Gema [3 ,4 ]
Haller, Hermann [6 ]
Schmieder, Roland E. [7 ]
Anker, Stefan D. [8 ,9 ]
Filippatos, Gerasimos [10 ]
Pitt, Bertram [11 ]
Rossing, Peter [12 ,13 ]
Lambelet, Marc [14 ]
Nowack, Christina [15 ]
Kolkhof, Peter [16 ]
Joseph, Amer [17 ]
Bakris, George L. [18 ]
机构
[1] Richard L Roudebush VA Med Ctr, Indianapolis, IN USA
[2] Indiana Univ, Indianapolis, IN 46204 USA
[3] Inst Res Imasl2, Cardiorenal Translat Lab & Hypertens Unit, Madrid, Spain
[4] Hosp Univ 12 Octubre, GIBER CV, Madrid, Spain
[5] European Univ Madrid, Fac Sport Sci, Madrid, Spain
[6] Hannover Med Sch, Dept Nephrol & Hypertens, Hannover, Germany
[7] Univ Hosp Erlangen, Dept Nephrol & Hypertens, Erlangen, Germany
[8] Charite, Dept Cardiol CVK, Berlin, Germany
[9] Charite, Berlin Inst Hlth Ctr Regenerat Therapies, German Ctr Cardiovasc Res Partner Site Berlin, Berlin, Germany
[10] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Sch Med, Dept Cardiol, Athens, Greece
[11] Univ Michigan, Sch Med, Dept Med, Ann Arbor, MI 48104 USA
[12] Steno Diabet Ctr Copenhagen, Herlev, Denmark
[13] Univ Copenhagen, Dept Clin Med, Copenhagen, Denmark
[14] Chrestos Concept GmbH & Co KG, Essen, Germany
[15] Bayer AG, Res & Dev, Wuppertal, Germany
[16] Bayer AG, Pharmaceut Cardiovasc Precis Med, Res & Dev, Wuppertal, Germany
[17] Bayer AG, Cardiol & Nephrol Clin Dev, Berlin, Germany
[18] Univ Chicago Med, Dept Med, Chicago, IL USA
关键词
albuminuria; ambulatory blood pressure monitoring; chronic kidney disease; finerenone; type; 2; diabetes; SELECTIVE ALDOSTERONE BLOCKER; CHRONIC HEART-FAILURE; MINERALOCORTICOID RECEPTOR; CARDIOVASCULAR EVENTS; BAY; 94-8862; TASK-FORCE; ASSOCIATION; MILD; PREVENTION; EPLERENONE;
D O I
10.1097/HJH.0000000000003330
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective: 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 m2 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 nighttime 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 24h 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.
引用
收藏
页码:295 / 302
页数:8
相关论文
共 23 条
[1]   Steroidal and non-steroidal mineralocorticoid receptor antagonists in cardiorenal medicine [J].
Agarwal, Rajiv ;
Kolkhof, Peter ;
Bakris, George ;
Bauersachs, Johann ;
Haller, Hermann ;
Wada, Takashi ;
Zannad, Faiez .
EUROPEAN HEART JOURNAL, 2021, 42 (02) :152-161
[2]   Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis [J].
Agarwal, Rajiv ;
Filippatos, Gerasimos ;
Pitt, Bertram ;
Anker, Stefan D. ;
Rossing, Peter ;
Joseph, Amer ;
Kolkhof, Peter ;
Nowack, Christina ;
Gebel, Martin ;
Ruilope, Luis M. ;
Bakris, George L. .
EUROPEAN HEART JOURNAL, 2022, 43 (06) :474-+
[3]   Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): a phase 2, randomised, double-blind, placebo-controlled trial [J].
Agarwal, Rajiv ;
Rossignol, Patrick ;
Romero, Alain ;
Garza, Dahlia ;
Mayo, Martha R. ;
Warren, Suzette ;
Ma, Jia ;
White, William B. ;
Williams, Bryan .
LANCET, 2019, 394 (10208) :1540-1550
[4]   Finerenone Impedes Aldosterone-dependent Nuclear Import of the Mineralocorticoid Receptor and Prevents Genomic Recruitment of Steroid Receptor Coactivator-1 [J].
Amazit, Larbi ;
Le Billan, Florian ;
Kolkhof, Peter ;
Lamribet, Khadija ;
Viengchareun, Say ;
Fay, Michel R. ;
Khan, Junaid A. ;
Hillisch, Alexander ;
Lombes, Marc ;
Rafestin-Oblin, Marie-Edith ;
Fagart, Jerome .
JOURNAL OF BIOLOGICAL CHEMISTRY, 2015, 290 (36) :21876-21889
[5]   Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes [J].
Bakris, George L. ;
Agarwal, Rajiv ;
Anker, Stefan D. ;
Pitt, Bertram ;
Ruilope, Luis M. ;
Rossing, Peter ;
Kolkhof, Peter ;
Nowack, Christina ;
Schloemer, Patrick ;
Joseph, Amer ;
Filippatos, Gerasimos .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (23) :2219-2229
[6]   Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy A Randomized Clinical Trial [J].
Bakris, George L. ;
Agarwal, Rajiv ;
Chan, Juliana C. ;
Cooper, Mark E. ;
Gansevoort, Ron T. ;
Haller, Hermann ;
Remuzzi, Giuseppe ;
Rossing, Peter ;
Schmieder, Roland E. ;
Nowack, Christina ;
Kolkhof, Peter ;
Joseph, Amer ;
Pieper, Alexander ;
Kimmeskamp-Kirschbaum, Nina ;
Ruilope, Luis M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (09) :884-894
[7]   Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure [J].
Chobanian, AV ;
Bakris, GL ;
Black, HR ;
Cushman, WC ;
Green, LA ;
Izzo, JL ;
Jones, DW ;
Materson, BJ ;
Oparil, S ;
Wright, JT ;
Roccella, EJ .
HYPERTENSION, 2003, 42 (06) :1206-1252
[8]   Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease [J].
de Pinho, Natalia Alencar ;
Levin, Adeera ;
Fukagawa, Masafumi ;
Hoy, Wendy E. ;
Pecoits-Filho, Roberto ;
Reichel, Helmut ;
Robinson, Bruce ;
Kitiyakara, Chagriya ;
Wang, Jinwei ;
Eckardt, Kai-Uwe ;
Jha, Vivekanand ;
Oh, Kook-Hwan ;
Sola, Laura ;
Eder, Susanne ;
de Borst, Martin ;
Taal, Maarten ;
Feldman, Harold I. ;
Stengel, Benedicte ;
Djurdjev, Ognjenka ;
Tang, Mila ;
Fujii, Naohiki ;
Maruyama, Shoichi ;
Imaizumi, Takahiro ;
Zhang, Jianzhen ;
Wang, Zaimin ;
Healy, Helen G. ;
Massy, Ziad A. ;
Combe, Christian ;
Laville, Maurice ;
Lopes, Antonio ;
Pisoni, Ronald ;
Bieber, Brian ;
Tu, Charlotte ;
Sangthawan, Pornpen ;
Pichaiwong, Warangkana ;
Klyprayong, Pinkaew ;
Orlandi, Paula ;
Townsend, Raymond ;
Go, Alan ;
Zhang, Luxia ;
Kumar, Vivek ;
Yadav, Ashok Kumar ;
Baid-Agrawal, Seema ;
Ahn, Curie ;
Chae, Dong Wan ;
Han, Seung Hyeok ;
Rios, Pablo G. ;
Gadola, Liliana ;
Lamadrid, Veronica ;
Leierer, Johannes .
KIDNEY INTERNATIONAL, 2019, 96 (04) :983-994
[9]   Daytime and nighttime blood pressure as predictors of death and cause-specific cardiovascular events in hypertension [J].
Fagard, Robert H. ;
Celis, Hilde ;
Thijs, Lutgarde ;
Staessen, Jan A. ;
Clement, Denis L. ;
De Buyzere, Marc L. ;
De Bacquer, Dirk A. .
HYPERTENSION, 2008, 51 (01) :55-61
[10]   Ambulatory Blood Pressure Reduction With SGLT-2 Inhibitors: Dose-Response Meta-analysis and Comparative Evaluation With Low-Dose Hydrochlorothiazide [J].
Georgianos, Panagiotis I. ;
Agarwal, Rajiv .
DIABETES CARE, 2019, 42 (04) :693-700