期刊
BRITISH JOURNAL OF PHARMACOLOGY
卷 179, 期 13, 页码 3220-3234出版社
WILEY
DOI: 10.1111/bph.15747
关键词
aldosterone; antagonist; cardiovascular disease; diabetic kidney disease; mineralocorticoid receptor; nonsteroidal
资金
- Deutsche Forschungsgemeinschaft [KI 712/10-1]
- Einstein Stiftung Berlin [EVF-BIH-2018-440]
- Bundesinstitut fur Risikobewertung [BfR1328-564]
- Deutsches Zentrum fur HerzKreislaufforschung [BER 5.4 PR]
This review provides information on the molecular pharmacology and relevant clinical data of a new class of non-steroidal MRAs, discussing their cardiorenal outcomes. These compounds have an improved benefit-risk profile in treating cardiovascular diseases, and finerenone has a novel indication.
Mineralocorticoid receptor antagonists (MRAs) are key agents in guideline-oriented drug therapy for cardiovascular diseases such as chronic heart failure with reduced ejection fraction and resistant hypertension. Currently available steroidal MRAs are efficacious in reducing morbidity and mortality; however, they can be associated with intolerable side effects including hyperkalaemia in everyday clinical practice. Recently, a new class of non-steroidal MRAs (including esaxerenone, AZD9977, apararenone, KBP-5074 and finerenone) have been developed with an improved benefit-risk profile and a novel indication for finerenone for diabetic kidney disease. To better understand the non-steroidal MRAs, this review provides information on the molecular pharmacology as well as relevant current preclinical and clinical data on cardiorenal outcomes. A comparative review of all compounds in the class is discussed with regard to clinical efficacy and safety as well as a perspective outlining their future use in clinical practice.
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