Cardiovascular effects of finerenone

Finerenone is the first non-steroidal antagonist of mineralocorticoid receptors (MCR), which has high affinity and selectivity for MCR, as well as significant differences from steroid analogs in physicochemical, pharmacodynamic and pharmacokinetic properties. A number of studies confirm the protective role of finerenone due to its anti-inflammatory, antifibrotic and antiremodeling effects in cardiac and renal tissues, which ensures clinical efficacy in reducing the incidence of cardiovascular outcomes. Clinical studies have demonstrated not only the renal-protective effect of finerenone, slowing the progression of chronic kidney disease (CKD), as assessed by the composite renal outcomes/death from renal causes, but also a reduction in the incidence of cardiovascular outcomes (including cardiovascular mortality, hospitalization for heart failure, non-fatal myocardial infarction and non-fatal stroke). Special studies have demonstrated a favorable effect of finerenone on the development of new-onset chronic heart failure (CHF) and CHF-related outcomes, regardless of the presence of CHF in the anamnesis. In addition, the effectiveness of finerenone in patients with CHF is observed across the entire range of ejection fraction (EF), reducing the risk of cardiovascular death and the incidence of hospitalization for CHF. All available data indicate that finerenone, being safe and well tolerated, has a high potential for preventing morbidity and mortality in a wide range of cardiorenal-metabolic syndrome conditions.