在1型糖尿病和慢性病中使用finerenone
Hiddo J L Heerspink1,2, Andreas L Birkenfeld3,4,5, David Z I Cherney6
1George Institute for Global Health, University of New South Wales, Sydney.
The New England journal of medicine
|March 4, 2026
概括
在患有1型糖尿病和慢性脏病 (CKD) 的成年人中,芬瑞显著降低了白蛋白尿症. 这种非类固醇矿物质皮质类受体对抗剂在六个月的时间内,与安慰剂相比,显示了25%的减少.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 菲内伦是一种非类固醇矿物质皮质类受体对抗剂,已在患有慢性病 (CKD) 的2型糖尿病患者中显示出好处.
- 在1型糖尿病和CKD患者中,芬瑞的疗效和安全性仍未确定.
- 这项研究解决了关于芬瑞对1型糖尿病和CKD的影响的知识差距.
研究的目的:
- 为了评估费内伦在1型糖尿病和CKD的成年人中的疗效和安全性.
- 评估菲内伦对该患者群体的白蛋白尿的影响.
- 为了比较尿中的白蛋白与肌素比率的降低,使用芬瑞诺和安慰剂.
主要方法:
- 进行了3期,随机的,安慰剂控制的试验.
- 参与者包括患有1型糖尿病,CKD和白蛋白尿症,接受ACE抑制剂或ARB治疗的参与者.
- 患者接受了finerenone (10或20毫克/天) 或安慰剂,主要结局是6个月的尿白蛋白与肌素比率的变化.
主要成果:
- 在6个月的时间里,费内伦导致尿中的白蛋白与肌素比率减少了34%,而安慰剂减少了12%.
- 这代表了具有统计学意义的25%更大的降低,用finerenone与安慰剂相比 (P<0.001).
- 超血是最常见的不良事件;用芬瑞龙观察到估计球过率 (eGFR) 略有下降,治疗后正常化.
结论:
- 在患有1型糖尿病和慢性结核病的成年人中,费内伦显著降低了结核病.
- 与安慰剂相比,该药物显示出尿路白与肌素比率的优异降低.
- 这些发现表明finerenone作为一种潜在的治疗选择来管理1型糖尿病中的脏疾病.
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