A major international clinical trial has found that finerenone can significantly slow the loss of kidney function in people with chronic kidney disease (CKD) who do not have diabetes. The findings suggest the drug could become an important new treatment option for a large group of patients who have historically had limited therapies beyond standard care.
The research was led by clinical pharmacologist Hiddo Lambers Heerspink of the University Medical Center Groningen and published in the New England Journal of Medicine.
Large International Trial Evaluates Finerenone
The FIND-CKD study enrolled 1,584 adults with chronic kidney disease and followed them for an average of just over three years. Every participant had impaired kidney function along with elevated levels of protein in the urine, which is a key warning sign that kidney damage may continue to worsen.
Participants were randomly assigned to receive either a daily dose of finerenone or a placebo. Both groups also continued receiving standard treatment with ACE inhibitors or angiotensin receptor blockers.
Slower Decline in Kidney Function
Researchers measured how kidney function changed over a 2.5 year follow up period using estimated glomerular filtration rate (eGFR), which reflects how effectively the kidneys filter waste from the blood.
Patients treated with finerenone experienced a statistically significant slowing in the decline of eGFR compared with those who received the placebo. According to Lambers Heerspink, the improvement was not only statistically significant but also meaningful in clinical practice.
Lower Risk of Kidney and Heart Complications
The study also showed that finerenone reduced the likelihood of serious health complications, including major kidney events, hospitalization for heart failure, and death from cardiovascular disease.
Lambers Heerspink said, “In the finerenone group, 13.9 percent experienced such a complication, compared to 16.9 percent in the placebo group. That amounts to a reduction in risk of approximately 23 percent.”
Protein in Urine Fell Sharply
Another important benefit was a substantial reduction in urinary protein, an early indicator of kidney damage.
Lambers Heerspink explained, “The presence of protein in the urine is often an important and early sign of kidney damage. In the finerenone group, it decreased by an average of over 41 percent, compared to about 9 percent in the placebo group. More than half of the patients who received finerenone achieved a reduction of at least 30 percent in the amount of protein in their urine. Such a reduction is an important indicator of a more favorable renal prognosis.”
Expanding Treatment Beyond Diabetes
Previous large clinical trials of finerenone mainly focused on people with type 2 diabetes. The new findings show the drug also provides meaningful benefits for patients with chronic kidney disease who do not have diabetes.
According to Lambers Heerspink, “Now it turns out the drug is also effective in people without diabetes, even though more than half of all CKD patients worldwide are non-diabetic. Chronic kidney disease now affects an estimated 800 million adults worldwide.”
A New Option for Non Diabetic CKD
The researchers also found that finerenone was safe to use throughout the study.
Lambers Heerspink said, “Finerenone could become an important new treatment option for people with chronic kidney disease who do not have diabetes. The drug offers a clear delay in the decline of kidney function on top of current standard care. The results provide physicians with new therapeutic options to help preserve kidney function and reduce the number of cardiovascular and renal complications. And this applies to a broad, underserved patient population with non-diabetic CKD, for whom there are few treatment options in the guidelines.”