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Network meta-analysis of mineralocorticoid receptor antagonists for diabetic kidney disease

FRONTIERS IN PHARMACOLOGY (2022)

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Review Medicine, General & Internal

Effectiveness of nonsteroidal mineralocorticoid receptor antagonists in patients with diabetic kidney disease

Edgar Lerma et al.

Summary: Nonsteroidal mineralocorticoid receptor antagonists (MRAs) are a new class of drugs developed to protect the kidney and the heart in patients with diabetic kidney disease (DKD). Finerenone and Esaxerenone are two effective nonsteroidal MRAs with good therapeutic effects and fewer side effects.

POSTGRADUATE MEDICINE (2023)

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Review Pharmacology & Pharmacy

Novel non-steroidal mineralocorticoid receptor antagonists in cardiorenal disease

Ulrich Kintscher et al.

Summary: 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.

BRITISH JOURNAL OF PHARMACOLOGY (2022)

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Article Medicine, Research & Experimental

The HDAC2/SP1/miR-205 feedback loop contributes to tubular epithelial cell extracellular matrix production in diabetic kidney disease

Zongji Zheng et al.

Summary: The feedback loop formed by HDAC2 and miR-205 plays a crucial role in regulating ECM production in tubular epithelial cells in individuals with DKD, suggesting its significance in the pathogenesis of DKD.

CLINICAL SCIENCE (2022)

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Article Endocrinology & Metabolism

11. Chronic Kidney Disease and Risk Management: Standards of Medical Care in Diabetes-2022

Summary: The American Diabetes Association (ADA) Standards of Medical Care in Diabetes provide comprehensive guidelines and tools for diabetes care. These standards are regularly updated by a professional committee to ensure their relevance and accuracy.

DIABETES CARE (2022)

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Review Pharmacology & Pharmacy

Clinical Pharmacokinetics and Pharmacodynamics of Esaxerenone, a Novel Mineralocorticoid Receptor Antagonist: A Review

Slobodan M. Jankovic et al.

Summary: Esaxerenone is a selective, nonsteroidal, high-affinity mineralocorticoid receptor antagonist approved in Japan for treating hypertension. It has high oral bioavailability and renoprotective action, and dose adjustment requires monitoring of serum potassium.

EUROPEAN JOURNAL OF DRUG METABOLISM AND PHARMACOKINETICS (2022)

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Article Physiology

Meta-Analysis of the Efficacy and Safety of Finerenone in Diabetic Kidney Disease

Yaning Zheng et al.

Summary: This study aimed to explore the efficacy and safety of finerenone in treating patients with diabetic kidney disease (DKD). The results showed that patients receiving finerenone treatment had a significant decrease in urinary albumin-to-creatinine ratio (UACR) and an improvement in renal function. However, the use of finerenone may increase the risk of hyperkalemia, with no difference in the risk of overall adverse events.

KIDNEY & BLOOD PRESSURE RESEARCH (2022)

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Review Urology & Nephrology

Mineralocorticoid receptor antagonists in diabetic kidney disease - mechanistic and therapeutic effects

Jonatan Barrera-Chimal et al.

Summary: Non-steroidal mineralocorticoid receptor antagonists (MRAs) show promising therapeutic effects in the treatment of diabetic kidney disease (DKD), including reducing albuminuria, slowing CKD progression, and lowering the risk of adverse cardiovascular outcomes. Compared with steroidal MRAs, non-steroidal MRAs carry a lower risk, providing potential for their use in the treatment of DKD.

NATURE REVIEWS NEPHROLOGY (2022)

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Article Urology & Nephrology

The Kidney Protective Effects of the Sodium-Glucose Cotransporter-2 Inhibitor, Dapagliflozin, Are Present in Patients With CKD Treated With Mineralocorticoid Receptor Antagonists

Michele Provenzano et al.

Summary: Dapagliflozin was equally safe and effective in reducing major adverse kidney outcomes in participants with CKD, regardless of whether they were prescribed MRAs at baseline.

KIDNEY INTERNATIONAL REPORTS (2022)

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Article Urology & Nephrology

Finerenone in Predominantly Advanced CKD and Type 2 Diabetes With or Without Sodium-Glucose Cotransporter-2 Inhibitor Therapy

Peter Rossing et al.

Summary: The FIDELIO-DKD study investigated the treatment effect of finerenone in patients with CKD and T2D, showing that finerenone can improve UACR and have beneficial effects on kidney and cardiovascular outcomes, regardless of whether patients were also using SGLT-2i.

KIDNEY INTERNATIONAL REPORTS (2022)

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Article Cardiac & Cardiovascular Systems

Sodium-Glucose Cotransporter 2 Inhibitors and Risk of Hyperkalemia in People With Type 2 Diabetes: A Meta-Analysis of Individual Participant Data From Randomized, Controlled Trials

Brendon L. Neuen et al.

Summary: SGLT2 inhibitors reduce the risk of serious hyperkalemia in people with type 2 diabetes at high cardiovascular risk or with chronic kidney disease without increasing the risk of hypokalemia.

CIRCULATION (2022)

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Review Peripheral Vascular Disease

Esaxerenone, a novel nonsteroidal mineralocorticoid receptor blocker (MRB) in hypertension and chronic kidney disease

Ningning Wan et al.

Summary: Esaxerenone, a novel nonsteroidal mineralocorticoid receptor blocker, has shown efficacy and good tolerability in treating hypertensive patients in Japan. In addition to lowering blood pressure, esaxerenone also demonstrates renoprotective effects. Clinical trials have indicated the potential clinical application of esaxerenone in treating renal diseases.

JOURNAL OF HUMAN HYPERTENSION (2021)

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Article Urology & Nephrology

Apararenone in patients with diabetic nephropathy: results of a randomized, double-blind, placebo-controlled phase 2 dose-response study and open-label extension study

Takashi Wada et al.

Summary: The study demonstrated the efficacy of apararenone in reducing UACR levels in patients with stage 2 diabetic nephropathy over 24 weeks, with safety and tolerability confirmed over 52 weeks of treatment.

CLINICAL AND EXPERIMENTAL NEPHROLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Finerenone and Cardiovascular Outcomes in Patients With Chronic Kidney Disease and Type 2 Diabetes

Gerasimos Filippatos et al.

Summary: The FIDELIO-DKD trial demonstrated that Finerenone reduced the incidence of cardiovascular outcomes in patients with chronic kidney disease and type 2 diabetes, with a composite outcome including cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure. There was no difference in the treatment effect based on preexisting cardiovascular disease status, with similar incidence of adverse events between treatment arms.

CIRCULATION (2021)

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Review Cardiac & Cardiovascular Systems

Aldosterone Blockade in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Qiao Chen et al.

Summary: Mineralocorticoid receptor antagonist treatment reduces all-cause mortality and cardiovascular adverse events in post-AMI patients, especially in patients after STEMI without LVSD. Additionally, MRA treatment may have beneficial effects on reversing cardiac remodeling in these patients.

CARDIOVASCULAR THERAPEUTICS (2021)

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Review Peripheral Vascular Disease

A systematic review and meta-analysis of effects of spironolactone on blood pressure, glucose, lipids, renal function, fibrosis and inflammation in patients with hypertension and diabetes

Mengyue Lin et al.

Summary: In patients with hypertension and diabetes, spironolactone significantly reduced blood pressure and urinary albumin, improved fibrosis and inflammation, while slightly increased glycosylated hemoglobin and serum creatinine.

BLOOD PRESSURE (2021)

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Editorial Material Urology & Nephrology

US Renal Data System 2020 Annual Data Report: Epidemiology of Kidney Disease in the United States

Kirsten L. Johansen et al.

AMERICAN JOURNAL OF KIDNEY DISEASES (2021)

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Review Peripheral Vascular Disease

Cardiovascular Protection With Sodium-Glucose Cotransporter-2 Inhibitors and Mineralocorticoid Receptor Antagonists in Chronic Kidney Disease A Milestone Achieved

Pantelis Sarafidis et al.

Summary: CKD and cardiovascular disease are closely linked, sharing risk factors and pathogenetic mechanisms. While ACE inhibitors and ARBs can delay CKD progression, their impact on cardiovascular events and mortality is limited. In contrast, SGLT-2 inhibitors and MRAs not only provide effective renal protection, but also offer important cardioprotection in this population.

HYPERTENSION (2021)

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Article Multidisciplinary Sciences

Loss of endothelial glucocorticoid receptor accelerates diabetic nephropathy

Swayam Prakash Srivastava et al.

Summary: The endothelial glucocorticoid receptor plays a crucial role in regulating diseases, with its loss associated with accelerated renal fibrosis and heightened inflammation. Proper regulation of endothelial cell homeostasis is essential in preventing diseases from progressing to organ fibrosis.

NATURE COMMUNICATIONS (2021)

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Article Urology & Nephrology

Effects of Finerenone Combined with Empagliflozin in a Model of Hypertension-Induced End-Organ Damage

Peter Kolkhof et al.

Summary: This study compared the effects of nonsteroidal MR antagonist finerenone and SGLT2 inhibitor empagliflozin as monotherapy and in combination in a preclinical model of hypertension-induced cardiorenal disease. The low-dose combination therapy showed superior outcomes in reducing proteinuria, blood pressure, plasma markers, and cardiorenal lesions compared to respective monotherapy dosages.

AMERICAN JOURNAL OF NEPHROLOGY (2021)

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Article Medicine, General & Internal

Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes

Bertram Pitt et al.

Summary: Finerenone therapy improved cardiovascular outcomes in patients with type 2 diabetes and stage 2 to 4 CKD with moderately elevated albuminuria or stage 1 or 2 CKD with severely elevated albuminuria, compared to placebo. The risk of the primary outcome event was significantly lower in the finerenone group, primarily driven by a reduction in hospitalization for heart failure.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Review Chemistry, Medicinal

Mineralocorticoid Receptor Antagonists in Diabetic Kidney Disease

Nina Vodosek Hojs et al.

Summary: Diabetes and chronic kidney disease are global health issues with a strong connection, as diabetic kidney disease affects a significant portion of diabetic patients. Non-steroidal mineralocorticoid receptor antagonists (MRA) have shown promise in treating DKD with fewer side effects compared to steroidal MRAs. Research in this area continues to expand to optimize treatment options.

PHARMACEUTICALS (2021)

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Article Genetics & Heredity

Inhibition of Angiotensin-Converting Enzyme Ameliorates Renal Fibrosis by Mitigating DPP-4 Level and Restoring Antifibrotic MicroRNAs

Swayam Prakash Srivastava et al.

GENES (2020)

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Article Medicine, General & Internal

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

George L. Bakris et al.

NEW ENGLAND JOURNAL OF MEDICINE (2020)

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Review Cardiac & Cardiovascular Systems

Mineralocorticoid Receptor Antagonists: a Comprehensive Review of Finerenone

Juan Simon Rico-Mesa et al.

CURRENT CARDIOLOGY REPORTS (2020)

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Article Urology & Nephrology

Esaxerenone (CS-3150) in Patients with Type 2 Diabetes and Microalbuminuria (ESAX-DN) Phase 3 Randomized Controlled Clinical Trial

Sadayoshi Ito et al.

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2020)

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Review Medicine, General & Internal

Aldosterone antagonists in addition to renin angiotensin system antagonists for preventing the progression of chronic kidney disease

Edmund Y. M. Chung et al.

COCHRANE DATABASE OF SYSTEMATIC REVIEWS (2020)

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Article Cell Biology

MiR-4756 promotes albumin-induced renal tubular epithelial cell epithelial-to-mesenchymal transition and endoplasmic reticulum stress via targeting Sestrin2

Yijie Jia et al.

JOURNAL OF CELLULAR PHYSIOLOGY (2019)

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Review Endocrinology & Metabolism

Mineralocorticoid Antagonism and Diabetic Kidney Disease

Yuliya Lytvyn et al.

CURRENT DIABETES REPORTS (2019)

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Review Integrative & Complementary Medicine

MicroRNAs in the Progress of Diabetic Nephropathy: A Systematic Review and Meta-Analysis

Li-ping Wang et al.

EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE (2019)

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Article Cardiac & Cardiovascular Systems

Comparative efficacy and safety of mineralocorticoid receptor antagonists in heart failure: a network meta-analysis of randomized controlled trials

Pingping Yang et al.

HEART FAILURE REVIEWS (2019)

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Article Urology & Nephrology

Efficacy and Safety of Esaxerenone (CS-3150) for the Treatment of Type 2 Diabetes with Microalbuminuria: A Randomized, Double-Blind, Placebo-Controlled, Phase II Trial

Sadayoshi Ito et al.

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2019)

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Review Pharmacology & Pharmacy

microRNA Crosstalk Influences Epithelial-to-Mesenchymal, Endothelial-to-Mesenchymal, and Macrophage-to-Mesenchymal Transitions in the Kidney

Swayam Prakash Sriyastava et al.

FRONTIERS IN PHARMACOLOGY (2019)

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Article Medicine, General & Internal

Efficacy and safety of mineralocorticoid receptor antagonists with ACEI/ARB treatment for diabetic nephropathy: A meta-analysis

Chao Zuo et al.

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE (2019)

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Article Peripheral Vascular Disease

Double-Blind Randomized Phase 3 Study Comparing Esaxerenone (CS-3150) and Eplerenone in Patients With Essential Hypertension (ESAX-HTN Study)

Sadayoshi Ito et al.

HYPERTENSION (2019)

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Review Medicine, General & Internal

The use of a novel non-steroidal mineralocorticoid receptor antagonist finerenone for the treatment of chronic heart failure A systematic review and meta-analysis

Hui Pei et al.

MEDICINE (2018)

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Article Cell Biology

SIRT3 deficiency leads to induction of abnormal glycolysis in diabetic kidney with fibrosis

Swayam Prakash Srivastava et al.

CELL DEATH & DISEASE (2018)

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Article Cardiac & Cardiovascular Systems

A meta-analysis of add-on use of spironolactone in patients with resistant hypertension

Di Zhao et al.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2017)

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Sirt6 deficiency exacerbates podocyte injury and proteinuria through targeting Notch signaling

Min Liu et al.

NATURE COMMUNICATIONS (2017)

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Diagnosis and Management of Type 2 Diabetic Kidney Disease

Simit M. Doshi et al.

CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2017)

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Spironolactone and glucose metabolism, a systematic review and meta-analysis of randomized controlled trials

Jie V. Zhao et al.

JOURNAL OF THE AMERICAN SOCIETY OF HYPERTENSION (2016)

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Article Endocrinology & Metabolism

A randomized controlled study of finerenone versus placebo in Japanese patients with type 2 diabetes mellitus and diabetic nephropathy

Shigehiro Katayama et al.

JOURNAL OF DIABETES AND ITS COMPLICATIONS (2016)

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Article Multidisciplinary Sciences

The coordinated roles of miR-26a and miR-30c in regulating TGFβ1-induced epithelial-to-mesenchymal transition in diabetic nephropathy

Zongji Zheng et al.

SCIENTIFIC REPORTS (2016)

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Review Pharmacology & Pharmacy

Emerging Roles of the Mineralocorticoid Receptor in Pathology: Toward New Paradigms in Clinical Pharmacology

F. Jaisser et al.

PHARMACOLOGICAL REVIEWS (2016)

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Spironolactone Add-on for Preventing or Slowing the Progression of Diabetic Nephropathy: A Meta-analysis

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Effect of Finerenone on Albuminuria in Patients With Diabetic Nephropathy A Randomized Clinical Trial

George L. Bakris et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2015)

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Renin-Angiotensin-Aldosterone System Blockade in Diabetic Nephropathy. Present Evidences

Luz Lozano-Maneiro et al.

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Evaluation of spironolactone plus hydrochlorothiazide in reducing proteinuria in type 2 diabetic nephropathy

Ali Momeni et al.

JOURNAL OF THE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (2015)

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Article Endocrinology & Metabolism

Diabetic Kidney Disease: A Report From an ADA Consensus Conference

Katherine R. Tuttle et al.

DIABETES CARE (2014)

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Article Urology & Nephrology

Histone deacetylase 4 selectively contributes to podocyte injury in diabetic nephropathy

Xiaojie Wang et al.

KIDNEY INTERNATIONAL (2014)

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Spironolactone treatment in patients with diabetic microalbuminuria and resistant hypertension

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INTERNATIONAL JOURNAL OF DIABETES IN DEVELOPING COUNTRIES (2012)

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Molecular pharmacology of the mineralocorticoid receptor: Prospects for novel therapeutics

Peter Kolkhof et al.

MOLECULAR AND CELLULAR ENDOCRINOLOGY (2012)

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Central regulation of blood pressure by the mineralocorticoid receptor

Elise P. Gomez-Sanchez et al.

MOLECULAR AND CELLULAR ENDOCRINOLOGY (2012)

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Albuminuria and Kidney Function Independently Predict Cardiovascular and Renal Outcomes in Diabetes

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Addition of Angiotensin Receptor Blockade or Mineralocorticoid Antagonism to Maximal Angiotensin-Converting Enzyme Inhibition in Diabetic Nephropathy

Uzma F. Mehdi et al.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2009)

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Change in proteinuria after adding aldosterone Blockers to ACE inhibitors or angiotensin receptor Blockers in CKD: A systematic review

Andrew S. Bomback et al.

AMERICAN JOURNAL OF KIDNEY DISEASES (2008)

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Article Medicine, General & Internal

Incident diabetes in clinical trials of anti hypertensive drugs: a network meta-analysis

William J. Elliott et al.

LANCET (2007)

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Spironolactone in type 2 diabetic nephropathy: effects on proteinuria, blood pressure and renal function

Anton H. van den Meiracker et al.

JOURNAL OF HYPERTENSION (2006)

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Selective aldosterone blockade with eplerenone reduces albuminuria in patients with type 2 diabetes

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