The effect of finerenone in reducing disease progression among patients with chronic kidney disease: A systematic review and meta-analysis

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Marie Angeline J. Mora*, Mariane Paula C. Agoncillo* and Rachel Anne C. Suite

St. Luke’s Medical Center, Philippines

: J Nephrol Ren Dis

Abstract

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Finerenone is a novel therapeutic option in patients with Chronic Kidney Disease (CKD) explored in the study of FIDELIO-DKD wherein use of non-steroidal mineralocorticoid receptor antagonists play a role in reducing proteinuria and preventing decline of estimated Glomerular Function Rate (eGFR). However, application of this drug in the Nephrology community has been slow. This meta-analysis aims to evaluate the role of Finerenone in decreasing disease progression of CKD using five published Randomized Control Trials retrieved from PubMed, ClinicalTrials and Google scholar utilizing the Chochrane risk of bias for quality assessment. With a confidence interval of 95%, forest plots were generated using the Revman Program. A pooled total of 14,973 patients were included in this study. The evidence suggests that finerenone has shown significant results with a primary outcome showing overall effect (0.86%, 95% CI [0.79-0.93] p=0.0004, I2=0%) on CKD disease progression as well as preventing further increase in Urine Albumin-Creatinine Ratio (UACR) (-.0.29%, 95% CI [-0.32 to -0.27], p ≤ 0.0001, I2 0%) favoring the use of finerenone. Among patients with CKD, use of finerenone compared to placebo delayed the decline in eGFR. Further studies are needed to evaluate the use of Angiotensin-Converting Enzyme inhibitor (ACEi), Angiotensin Receptor Blocker (ARB), Sodium-Glucose cotransporter inhibitor (SGLT2) and other active medications in conjunction with finerenone. Keywords: Finerenone, Mineralocorticoid receptor antagonist, Chronic kidney disease, Meta-analysis.

Biography

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Marie Angeline J. Mora and Mariane Paula C. Agoncillo are both in their second year of residency in Internal Medicine at St. Luke’s Medical Center Quezon City. They both graduated from the same medical school at University of Santo Tomas in Manila. They are interested in the field of Nephrology and together with their adviser and a nephrology specialist, Dr. Rachel Anne C. Siute they have created this meta-analysis on Finerenone a reality.