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Published on: October 13, 2023
Effect and Safety of Finerenone in Patients with IgA Nephropathy
Yanhong Guo1, Xuewen Zhang1, Silu Zhao1
1Department of Nephropathy, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, People's Republic of China.
Purpose:
The study aimed to retrospectively evaluate the efficacy and safety of finerenone in patients diagnosed with IgA nephropathy.
Methods:
42 IgA nephropathy patients treated with finerenone combined with renin-angiotensin system inhibitor (RASI) and 42 patients who received RASI monotherapy were included in this study. The follow-up duration was 3 months. The efficacy and safety of finerenone were assessed based on key parameters, including urine protein creatinine ratio (UPCR), estimated glomerular filtration rate (eGFR), serum creatinine, serum albumin, hematuria, and serum potassium at 1 and 3 months after treatment initiation.
Results:
This study demonstrated that finerenone combined with RASI significantly reduced proteinuria in IgA nephropathy patients. Two-way repeated measures ANOVA revealed a significant time * treatment interaction (P = 0.032), and subsequent one-way repeated measures ANOVA showed a marked decline in log-transformed UPCR over time in the combination group (P < 0.001) but not in the monotherapy group (P = 0.187). Correspondingly, the combination group achieved a 27.29% reduction in UPCR at one month (95% CI: 13.47-39.68%, P = 0.017) and a 34.17% reduction at three months (95% CI: 21.84-52.75%, P < 0.001) compared to baseline, whereas RASI monotherapy failed to show any significant proteinuria-reduction effects. Notably, the antiproteinuric effect was consistent across subgroups. Serum potassium and creatinine levels remained stable, and no adverse events related to hyperkalemia were observed.
Conclusion:
The retrospective evaluation suggests that finerenone combined with RASI effectively reduced proteinuria in IgA nephropathy patients, underscoring its potential as a viable treatment option for this patient population.
Insights
Finerenone combined with renin-angiotensin system inhibitors (RASi) significantly reduced proteinuria in IgA nephropathy patients. This combination therapy demonstrated efficacy and safety, offering a potential new treatment option for IgA nephropathy.
Area of Science:
- Nephrology
- Pharmacology
Background:
- Immunoglobulin A nephropathy (IgA nephropathy) is a common primary glomerulonephritis.
- Proteinuria is a key indicator of IgA nephropathy progression and a target for treatment.
Purpose of the Study:
- To retrospectively evaluate the efficacy and safety of finerenone in combination with renin-angiotensin system inhibitors (RASi) for IgA nephropathy patients.
- To assess the impact of finerenone on proteinuria and kidney function markers.
Main Methods:
- Retrospective study including 84 IgA nephropathy patients (42 in finerenone + RASi group, 42 in RASi monotherapy group).
- Follow-up duration of 3 months.
- Key parameters assessed: urine protein creatinine ratio (UPCR), estimated glomerular filtration rate (eGFR), serum creatinine, serum albumin, hematuria, and serum potassium.
Main Results:
- Finerenone + RASi significantly reduced UPCR by 27.29% at 1 month and 34.17% at 3 months compared to baseline (P < 0.001).
- RASi monotherapy did not show significant reduction in proteinuria.
- Serum potassium and creatinine levels remained stable, with no hyperkalemia-related adverse events.
Conclusions:
- Finerenone in combination with RASi is effective in reducing proteinuria in IgA nephropathy patients.
- The combination therapy shows a favorable safety profile regarding potassium and creatinine levels.
- Finerenone represents a potential therapeutic option for managing IgA nephropathy.
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