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Effect of finerenone on cardiovascular events in kidney disease and/or diabetes: a meta analysis of randomized control trials

  • Nephrology - Original Paper
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Abstract

Objective

To evaluate the effect of finerenone on cardiovascular events in Kidney Disease and/or Diabetes.

Methods

The ClinicalTrials.gov, Medline, EMBASE, Web of Science, Cochrane Library databases were systematically searched from the inception dates to December 20, 2021 in order to identify randomized controlled trials that evaluated the effect of finerenone on cardiovascular events in Kidney Disease and/or Diabetes, without language restriction. This meta-analysis collected data from 7 randomized clinical trials that evaluated the effect of finrrenone in 15,618 patients with kidney disease and/or diabetes. Risk of bias was assessed by Cochrane Risk of Bias Assessment Tool. Inconsistency among trial results was assessed by I2 statistic. The main endpoints included death from cardiovascular causes, death from any cause, incidence of myocardial infarction, rate of heart failure, hospitalization for any cause, rate of total advent events and study-drug-related adverse events.

Results

A total of 7 randomized controlled trials involving 15,618 fulfilled the inclusion criteria. The outcomes of this meta-analysis presented that finerenone significantly reduced the death from any cause (95% CI 0.82–0.99; P = 0.031), risk of heart failure (95% CI 0.67–0.92; P = 0.002) among patients with kidney disease and/or diabetes when compared to control group. Besides, finerenone could not reduce the incidence of death from cardiovascular, myocardial infarction and hospitalization for any cause among patients with kidney disease and/or diabetes (p > 0.05). In terms of safety, finerenone shared the same risk of total advent events with placebo among patients with kidney disease and/or diabetes (p > 0.05). However, finerenone had higher risk of study-drug-related advent events than placebo among patients with kidney disease and/or diabetes (95% CI 1.27–1.48; P < 0.001).

Conclusions

In patients with kidney disease and/or diabetes, treatment with finerenone resulted in lower risk of death from any cause and heart failure than placebo. However, the study-drug-related advent events also increased significantly at the same time.

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Data availability

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

All of the authors had no any personal, financial, commercial, or academic conflicts of interest separately. This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of our hospital. No funding or sponsorship was received for this study or publication of this article.

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Authors and Affiliations

  1. Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Intensive Care Unit department, No. 23, Mei Shu Guan Hou Jie, Dongcheng District, Zip Code: 100010, Beijing, China

    Yuhan Zhu, Maifen Song, Tengfei Chen & Zhihai Yang

  2. YEDA Hospital, Yantai, China

    Yanyan Liu

Authors
  1. Yuhan Zhu
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  2. Maifen Song
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  3. Tengfei Chen
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Correspondence to Yuhan Zhu or Yanyan Liu.

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Zhu, Y., Song, M., Chen, T. et al. Effect of finerenone on cardiovascular events in kidney disease and/or diabetes: a meta analysis of randomized control trials. Int Urol Nephrol 55, 1373–1381 (2023). https://doi.org/10.1007/s11255-022-03432-w

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  • DOI: https://doi.org/10.1007/s11255-022-03432-w

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