Side Effects of finerenone: A Synthesis of Findings from 24 Studies

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Original Abstract of the Article

Key Research Findings

Finerenone, a new non-steroidal mineralocorticoid receptor antagonist, has shown promising results in treating cardiovascular complications in patients with chronic kidney disease (CKD). 22 study using a mouse model demonstrated that finerenone improved both systolic and diastolic dysfunction in the heart caused by CKD and suppressed cardiac fibrosis. 18 study further showed that finerenone improved muscle function in a preclinical model of Duchenne muscular dystrophy. 6 review article provided evidence suggesting that finerenone improved cardiac and renal function in patients with CKD associated with type 2 diabetes, reducing the risk of cardiovascular events and kidney failure. A meta-analysis, 7 , also indicated that finerenone has a protective effect on the kidneys and heart in patients with CKD associated with type 2 diabetes.

Reasons for Side Effects

Finerenone is a mineralocorticoid receptor (MR) antagonist. MR is a receptor to which hormones such as aldosterone bind, playing a crucial role in regulating electrolyte balance and blood pressure in the body. By inhibiting MR, finerenone weakens the effects of aldosterone. Inhibition of MR can cause changes in electrolyte balance and a decrease in blood pressure. These changes are thought to manifest as side effects.

Common Side Effects

Hyperkalemia

By inhibiting MR, finerenone may inhibit potassium excretion in the kidneys and increase the potassium concentration in the blood. 6 review article showed that finerenone has a lower risk of hyperkalemia compared to traditional steroidal MR antagonists. However, hyperkalemia can cause serious complications, especially in patients with impaired kidney function, so caution is required. 5 review article showed that finerenone had fewer side effects and did not worsen kidney function compared to traditional steroidal MR antagonists.

Hyponatremia

Finerenone may inhibit sodium reabsorption in the kidneys, leading to a decrease in blood sodium concentration by inhibiting MR. 6 review article indicated that finerenone has a low risk of hyponatremia.

Hypertension

Finerenone may decrease blood pressure by inhibiting MR. 6 review article showed that finerenone has a lower risk of hypertension compared to traditional steroidal MR antagonists.

Headache

Finerenone may cause side effects such as headaches. 7 meta-analysis showed that there was no significant difference in side effects such as headaches between finerenone and placebo groups.

Gastrointestinal Symptoms

Finerenone may cause gastrointestinal symptoms such as nausea, vomiting, and abdominal pain. 7 meta-analysis showed that there was no significant difference in gastrointestinal symptoms or other side effects between finerenone and placebo groups.

Sexual Dysfunction

Finerenone may cause sexual dysfunction such as erectile dysfunction and decreased libido. 1 research showed that finasteride, another drug, can cause side effects such as sexual dysfunction. Like finasteride, finerenone may cause side effects such as sexual dysfunction, but currently there is insufficient specific data on this side effect.

Countermeasures for Side Effects

Hyperkalemia

Countermeasures for hyperkalemia include potassium restriction, administration of potassium-excreting drugs, etc. 6 review article showed that finerenone has a lower risk of hyperkalemia compared to traditional steroidal MR antagonists. However, hyperkalemia can cause serious complications, especially in patients with impaired kidney function, so caution is required.

Hyponatremia

Countermeasures for hyponatremia include increasing sodium intake and administering sodium supplements. 6 review article indicated that finerenone has a low risk of hyponatremia.

Hypertension

Countermeasures for hypertension include administration of antihypertensive drugs. 6 review article showed that finerenone has a lower risk of hypertension compared to traditional steroidal MR antagonists.

Comparison Between Studies

Similarities Between Studies

Many studies have shown that finerenone has improved cardiovascular complications and protected kidney function in patients with CKD. In addition, finerenone has been shown to have a lower risk of hyperkalemia compared to traditional steroidal MR antagonists.

Differences Between Studies

Some studies have shown that finerenone reduces the risk of cardiovascular events and kidney failure. 6 review article showed that finerenone improved cardiac and renal function in patients with CKD associated with type 2 diabetes, reducing the risk of cardiovascular events and kidney failure. On the other hand, other studies have shown that the effects of finerenone are limited. 14 research indicated that the effect of finerenone on reducing the risk of cardiovascular events in patients with CKD associated with type 2 diabetes was limited.

Precautions for Application in Real Life

Finerenone is expected to suppress cardiovascular complications and worsening kidney function in patients with CKD. However, finerenone can cause side effects such as hyperkalemia. Therefore, it is important to follow your doctor's instructions carefully and have regular blood tests when using finerenone. Additionally, patients with impaired kidney function, elderly patients, and pregnant or breastfeeding women should exercise caution when using finerenone. 12 research showed that finerenone improved cardiac and renal function in patients with CKD associated with type 2 diabetes, reducing the risk of cardiovascular events and kidney failure. However, the use of finerenone needs to be carefully considered based on the individual patient's condition.

Limitations of Current Research

Finerenone is a new drug, and further research is needed on long-term effects and safety. Furthermore, finerenone is not necessarily effective for all CKD patients. 16 paper suggests that finerenone is expected to improve cardiac and renal function in CKD patients, but further research is required. 13 paper suggests that finerenone is expected to be a safer drug for CKD patients compared to traditional steroidal MR antagonists. However, further research is needed.

Future Research Directions

Further research is needed on the long-term effects and safety of finerenone. Detailed research is also needed on which CKD patients are effective for and to what extent. Furthermore, research on appropriate administration methods and combination therapies to maximize the effectiveness of finerenone is also needed. 4 review article showed that finerenone has the effect of delaying the progression of CKD, but further research is needed.

Conclusion

Finerenone is a promising new treatment for cardiovascular complications and worsening kidney function in patients with CKD. Finerenone has been shown to have a lower risk of side effects such as hyperkalemia compared to traditional steroidal MR antagonists. However, finerenone is a new drug, and further research is needed on long-term effects and safety. It is important to follow your doctor's instructions carefully and have regular blood tests when using finerenone. 3 review article indicates that finerenone is a promising new treatment for cardiovascular complications and worsening kidney function in patients with CKD, but further research is needed.

Literature analysis of 24 papers
Positive Content
22
Neutral Content
0
Negative Content
2
Article Type
4
1
2
15
23
1.

Finasteride 5 mg and sexual side effects: how many of these are related to a nocebo phenomenon?

Author: MondainiNicola, GonteroPaolo, GiubileiGianluca, LombardiGiuseppe, CaiTommaso, GavazziAndrea, BartolettiRiccardo

Ejaculation disorders
Erectile dysfunction
Libido loss

Erectile dysfunction, loss of libido, and ejaculation disorders are consistent side effects of finasteride in up to 15% of patients after 1 year of therapy.

Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Efficacy and safety of 3% minoxidil versus combined 3% minoxidil / 0.1% finasteride in male pattern hair loss: a randomized, double-blind, comparative study.

Author: TanglertsampanChuchai

AGA treatment
Minoxidil/finasteride efficacy

Combined 3% minoxidil and 0.1% finasteride lotion was more effective than 3% minoxidil lotion in treating androgenetic alopecia without causing significant side effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Cardiovascular and Renal Benefit of Novel Non-steroidal Mineralocorticoid Antagonists in Patients with Diabetes.

Author: KintscherUlrich

Improved benefit-risk profile

Non-steroidal mineralocorticoid receptor antagonists are a new class of drugs with improved safety profiles compared to steroidal MRAs. This review discusses the pharmacology of these drugs and their potential applications in cardiorenal disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

4.

The role of a novel mineralocorticoid receptor antagonist, finerenone, in chronic kidney disease: mechanisms and clinical advances.

Author: ChenXinping, LiXuan, ZhangKexin, LianKexin, ZhangWenqiang, SongYixin, KanChengxia, ZhangJingwen, HanFang, SunXiaodong, GuoZhentao

Reduced hyperkalemia risk
Slow CKD progression

Finerenone is a selective mineralocorticoid receptor antagonist that is being investigated as a potential treatment for chronic kidney disease (CKD). This review summarizes the role and efficacy of finerenone in CKD treatment, highlighting its ability to slow the progression of CKD and its favorable safety profile.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

The Nonsteroidal Mineralocorticoid-Receptor-Antagonist Finerenone in Cardiorenal Medicine: A State-of-the-Art Review of the Literature.

Author: GeorgianosPanagiotis I, AgarwalRajiv

Cardiorenal protection
Reduced cardiovascular and kidney failure risk
Hyperkalemia

Finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, has been approved for cardiorenal protection in patients with CKD associated with T2DM. Two phase 3 clinical trials, FIDELIO-DKD and FIGARO-DKD, demonstrated its efficacy in reducing cardiovascular and kidney failure risks.

ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

7.

Efficacy and safety of finerenone in chronic kidney disease associated with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials.

Author: BaoWujisiguleng, ZhangMingzhu, LiNing, YaoZhi, SunLuying

CKD treatment
Cardiovascular protection
Renal protection
Hyperkalemia

Finerenone demonstrated significant renal and cardiovascular benefits in patients with CKD associated with T2D. The observed benefits were not outweighed by unacceptable side effects.

Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

8.

Finerenone in diabetic kidney disease: A systematic review and critical appraisal.

Author: SinghAwadhesh Kumar, SinghAkriti, SinghRitu, MisraAnoop

CKD treatment
T2D treatment

This systematic review aims to assess the efficacy and safety of finerenone in patients with chronic kidney disease (CKD) with or without type 2 diabetes (T2D).

Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

13.

Novel non-steroidal mineralocorticoid receptor antagonists in cardiorenal disease.

Author: KintscherUlrich, BakrisGeorge L, KolkhofPeter

Cardiovascular disease treatment
Hypertension treatment
Hyperkalemia

Non-steroidal mineralocorticoid receptor antagonists (MRAs) are a new class of drugs with improved benefit-risk profiles compared to steroidal MRAs. They have potential applications in treating cardiovascular diseases and diabetic kidney disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

14.

Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes.

Author: PittBertram, FilippatosGerasimos, AgarwalRajiv, AnkerStefan D, BakrisGeorge L, RossingPeter, JosephAmer, KolkhofPeter, NowackChristina, SchloemerPatrick, RuilopeLuis M,

Improved cardiorenal outcomes
Unclear wider CKD use

This article discusses the use of finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, in patients with type 2 diabetes and chronic kidney disease (CKD).

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease.

Author: Vodošek HojsNina, BevcSebastjan, EkartRobert, PikoNejc, PetreskiTadej, HojsRadovan

Cardiorenal benefits
Reduced hyperkalemia

This review summarizes the current knowledge and research on mineralocorticoid receptor antagonists (MRA) in the treatment of diabetic kidney disease (DKD). Non-steroidal MRAs have shown promise as they block the damaging effects of mineralocorticoid receptor overactivation with fewer side effects than steroidal MRAs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

The expanding class of mineralocorticoid receptor modulators: New ligands for kidney, cardiac, vascular, systemic and behavioral selective actions.

Author: BădilăE

Chronic kidney disease treatment
Heart failure treatment
Hyperkalemia

Nonsteroidal mineralocorticoid receptor antagonists, such as finerenone, show promise in treating chronic kidney disease and heart failure, as they provide renoprotective effects and inhibit inflammation without the side effects of traditional steroid-based antagonists.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

17.

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes.

Author: BakrisGeorge L, AgarwalRajiv, AnkerStefan D, PittBertram, RuilopeLuis M, RossingPeter, KolkhofPeter, NowackChristina, SchloemerPatrick, JosephAmer, FilippatosGerasimos,

CKD progression
Cardiovascular events
Hyperkalemia

This double-blind trial evaluated the long-term effects of finerenone on kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes. The study found that treatment with finerenone resulted in lower risks of CKD progression and cardiovascular events than placebo.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
CommentA short article/note that provides an opinion/perspective/interpretation on a published paper/topic.

Language : English

18.

Mineralocorticoid receptor antagonism by finerenone is sufficient to improve function in preclinical muscular dystrophy.

Author: LoweJeovanna, KolkhofPeter, HauptMichael J, PeczkowskiKyra K, RastogiNeha, HauckJ Spencer, KadakiaFeni K, ZinsJonathan G, CicconePierce C, SmartSuzanne, SandnerPeter, RamanSubha V, JanssenPaul M L, Rafael-FortneyJill A

Anti-fibrotic effect
Muscle function improvement
Cardiovascular disease risk
Osteoporosis
Weight gain

This study investigates the efficacy of finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), as a monotherapy in a preclinical model of Duchenne muscular dystrophy (DMD). The study aims to evaluate finerenone's potential as a treatment for DMD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

19.

New mineralocorticoid receptor antagonists: update on their use in chronic kidney disease and heart failure.

Author: CapelliIrene, GasperoniLorenzo, RuggeriMarco, DonatiGabriele, BaraldiOlga, SorrentiGiovanni, CalettiMaria Turchese, AielloValeria, CiancioloGiuseppe, La MannaGaetano

CHF prevention
CKD progression prevention
Hyperkalemia
Low safety profile

This study reviewed the effects of aldosterone and the development of nonsteroidal mineralocorticoid receptor antagonists (MRAs) to avoid the adverse effects of steroidal MRAs. The study summarized the results of preclinical and clinical studies on apararenone, esaxerenone, and finerenone, suggesting that nonsteroidal MRAs represent a promising new therapeutic approach for preventing heart failure (CHF) and chronic kidney disease (CKD) progression.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Mineralocorticoid Antagonism and Diabetic Kidney Disease.

Author: LytvynYuliya, GodoyLucas C, ScholtesRosalie A, van RaalteDaniël H, CherneyDavid Z

Cardiovascular disease prevention
Diabetes treatment
Kidney disease prevention
Residual cardiorenal morbidity

Type 2 diabetes is associated with a higher risk of kidney disease, cardiovascular disease, and heart failure. While newer medications like SGLT-2 inhibitors and GLP-1 receptor agonists help reduce these risks, there's still a need for better treatments. This review explores the potential of novel mineralocorticoid receptor antagonists (MRAs) to further reduce these complications in people with type 2 diabetes.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

Mineralocorticoids and Cardiovascular Disease in Females with Insulin Resistance and Obesity.

Author: NayyarManav, LastraGuido, AcevedoCamila Manrique

Cardiovascular disease
Mineralocorticoid receptor activation
Obesity

This review discusses the evidence and mechanisms underlying the complex interplay between obesity, mineralocorticoid receptor activation, and cardiovascular dysfunction with a special focus on the pathogenesis of cardiovascular disease (CVD) in obese and insulin-resistant females.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

Mineralocorticoid receptor antagonism improves diastolic dysfunction in chronic kidney disease in mice.

Author: BonnardBenjamin, Pieronne-DeperroisMarie, DjeradaZoubir, ElmoghrabiSoumaya, KolkhofPeter, Ouvrard-PascaudAntoine, MulderPaul, JaisserFrédéric, MessaoudiSmail

CKD complications
Prevent cardiac dysfunction
Hyperkalemia

Finerenone, a new non-steroidal mineralocorticoid receptor antagonist (MRA), was found to prevent cardiac complications of renal failure in a mouse model of chronic kidney disease (CKD). Finerenone improved cardiac function and reduced fibrosis without affecting renal dysfunction or potassium levels.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Nonsteroidal mineralocorticoid antagonists in diabetic kidney disease.

Author: DojkiFarheen K, BakrisGeorge

DKD treatment

Excess aldosterone may play a role in diabetic kidney disease (DKD) by promoting glomerular hypertrophy, glomerulosclerosis, and proteinuria. Nonsteroidal mineralocorticoid receptor antagonists (MRAs) are being investigated as potential treatments for DKD.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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