PMID- 35197856
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220225
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Efficacy and Safety of Finerenone in Chronic Kidney Disease: A Systematic Review 
      and Meta-Analysis of Randomized Clinical Trials.
PG  - 819327
LID - 10.3389/fphar.2022.819327 [doi]
LID - 819327
AB  - Background: Chronic kidney disease (CKD) is a global public health issue. In 
      recent years, the effectiveness of finerenone for treatment of CKD has been the 
      subject of considerable debate. The main objective of the current meta-analysis 
      was to validate the clinical efficacy and safety of finerenone in patients with 
      CKD. Methods: Seven databases were searched for randomized controlled trials 
      (RCTs) comparing finerenone with placebo in patients with CKD. Data from eligible 
      studies were extracted, and the Cochrane risk of bias tool utilized for 
      evaluating the methodological quality of RCTs. The effect size was estimated 
      using the risk ratio (RR) and mean difference (MD) with 95% confidence interval 
      (CI). Results: Five trials (n = 13,078) were included. Compared to placebo 
      groups, the urinary albumin-to-creatinine ratio (UACR) mean from the baseline was 
      significantly lower [MD -0.30 (95% CI -0.32, -0.28), p < 0.00001], while a 
      decrease in the estimated glomerular filtration rate (eGFR) from baseline was 
      significantly higher [MD -2.44 (95% CI -2.82, -2.05), p < 0.00001] for the 
      finerenone groups. Furthermore, the proportion of patients with decreased eGFR 
      (>/=40%) post-baseline was significantly lower [RR 0.85 (95% CI 0.78, 0.93), p = 
      0.0002], along with end-stage kidney disease (ESKD) [RR 0.80 (95% CI 0.65, 0.99), 
      p = 0.04] and cardiovascular events (CVs) [RR 0.88 (95% CI 0.80, 0.95), p < 
      0.003] in the finerenone groups. In terms of safety, the increase in the serum 
      potassium concentration and incidence of hyperkalemia was significantly higher 
      for the finerenone groups [MD 0.17 (95% CI 0.10, 0.24), p < 0.00001; RR 2.03 (95% 
      CI 1.83, 2.26), p < 0.00001, respectively], but the incidence of adverse events 
      (AEs) was similar to placebo [RR 1.00 (95% CI 0.98-1.01), p = 0.67]. In all 
      cases, the results were rated as providing moderate-quality or high-quality 
      evidence. Conclusion: Data from our meta-analysis suggest that finerenone confers 
      significant renal and cardiovascular benefits in patients with CKD. While higher 
      risk of hyperkalemia was observed with finerenone than placebo, differences in 
      AEs were not significant. Finerenone may therefore present a novel promising 
      therapeutic agent for patients with CKD. Systematic Review Registration: 
      [https://inplasy.com/inplasy-2021-9-0020/], identifier [INPLASY202190020].
CI  - Copyright (c) 2022 Zhang, Bao, Zheng, Wang and Sun.
FAU - Zhang, Ming-Zhu
AU  - Zhang MZ
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, 
      Beijing, China.
AD  - Renal Research Institution of Beijing University of Chinese Medicine, Beijing, 
      China.
FAU - Bao, Wujisiguleng
AU  - Bao W
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, 
      Beijing, China.
AD  - Renal Research Institution of Beijing University of Chinese Medicine, Beijing, 
      China.
FAU - Zheng, Qi-Yan
AU  - Zheng QY
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, 
      Beijing, China.
AD  - Renal Research Institution of Beijing University of Chinese Medicine, Beijing, 
      China.
FAU - Wang, Ya-Hui
AU  - Wang YH
AD  - Fangshan Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 
      China.
FAU - Sun, Lu-Ying
AU  - Sun LY
AD  - Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, 
      Beijing, China.
AD  - Renal Research Institution of Beijing University of Chinese Medicine, Beijing, 
      China.
AD  - Fangshan Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 
      China.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220207
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8859447
OTO - NOTNLM
OT  - chronic kidney disease
OT  - finerenone
OT  - meta-analysis
OT  - randomized clinical trials
OT  - systematic review
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/02/25 06:00
MHDA- 2022/02/25 06:01
PMCR- 2022/02/07
CRDT- 2022/02/24 05:41
PHST- 2021/11/21 00:00 [received]
PHST- 2022/01/10 00:00 [accepted]
PHST- 2022/02/24 05:41 [entrez]
PHST- 2022/02/25 06:00 [pubmed]
PHST- 2022/02/25 06:01 [medline]
PHST- 2022/02/07 00:00 [pmc-release]
AID - 819327 [pii]
AID - 10.3389/fphar.2022.819327 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 Feb 7;13:819327. doi: 10.3389/fphar.2022.819327. 
      eCollection 2022.