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Effectiveness and safety of finerenone in membranous nephropathy patients: a retrospective, real‑world study
Haowen Lin1, Qingqing Gao2, Yuhe Yin2
1Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, 510000, China.
Purpose:
We aimed to conduct a retrospective analysis to assess the efficacy and safety of finerenone in patients with membranous nephropathy (MN).
Methods:
This study conducted a retrospective analysis of patients with MN who were treated with finerenone for follow-up period ranging from 3 to 6 months. The study compared the estimated glomerular filtration rate (eGFR), urine total protein-to-creatinine ratio (PCR), urine albumin-to-creatinine ratio (ACR), serum creatinine concentration (SCr), blood pressure and serum potassium (K+) during the follow-up period.
Result:
In this study, 20 patients with MN were treated with finerenone for a follow-up period of 3 to 6 months. Prior to treatment, the average eGFR was 65.15 mL/min/1.73 m2, the average PCR was 3643.63 mg/g, and the average ACR was 2489.44 mg/g. After 3 months of treatment, 80% of patients experienced a decrease in PCR. The median decrease percentages in PCR and ACR are 24.49% and 28.82%, respectively. After 6 months of treatment, the median decrease percentages in PCR and ACR are 42.03% and 43.66%, respectively while the eGFR remained stable with little variation from baseline. During the treatment period, there were minimal changes in serum potassium levels and serum creatinine levels and no treatment discontinuations or hospitalizations due to hyperkalemia were observed. Blood pressure decreased by about 10 mmHg in 6 patients (30%), while there was no difference before and after the addition of finerenone in the remaining 14 (70%) patients.
Conclusion:
The retrospective analysis indicates that finerenone treatment led to significant reductions in PCR and ACR in patients with membranous nephropathy over a 3 to 6-month period, with minimal impact on eGFR, SCr, and K+ levels, highlighting its capacity as a therapeutic option for MN patient group.
Insights
Finerenone significantly reduced protein and albumin levels in patients with membranous nephropathy (MN) over 3-6 months. The treatment showed minimal impact on kidney function and electrolytes, indicating its potential as a therapeutic option for MN.
Area of Science:
- Nephrology
- Pharmacology
- Internal Medicine
Background:
- Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults.
- Current treatments for MN have limitations and variable efficacy.
- Finerenone, a non-steroidal mineralocorticoid receptor antagonist, has shown potential in kidney diseases.
Purpose of the Study:
- To assess the efficacy and safety of finerenone in patients diagnosed with membranous nephropathy (MN).
- To evaluate the impact of finerenone on proteinuria, kidney function, and blood pressure in MN patients.
Main Methods:
- Retrospective analysis of 20 MN patients treated with finerenone for 3-6 months.
- Comparison of estimated glomerular filtration rate (eGFR), protein-to-creatinine ratio (PCR), albumin-to-creatinine ratio (ACR), serum creatinine (SCr), blood pressure, and serum potassium (K+) before and during treatment.
Main Results:
- Significant reductions in PCR (median 42.03%) and ACR (median 43.66%) were observed after 6 months.
- eGFR remained stable, with minimal changes in SCr and K+ levels.
- No treatment discontinuations or hyperkalemia-related hospitalizations occurred.
- Blood pressure decreased in 30% of patients.
Conclusions:
- Finerenone treatment leads to significant reductions in proteinuria (PCR and ACR) in MN patients.
- The drug demonstrates a favorable safety profile with minimal impact on kidney function and electrolytes.
- Finerenone presents a promising therapeutic option for managing membranous nephropathy.
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