Bayer's Kerendia (finerenone), a nonsteroidal mineralocorticoid receptor antagonist (MRA), has demonstrated positive results in the Phase 3 FINEARTS-HF trial, showing a 16% reduction in the risk of cardiovascular death and first and recurrent heart failure events compared to placebo. The findings suggest a potential new treatment option for heart failure (HF) patients with an ejection fraction greater than 40%. These results could broaden Kerendia's application beyond its current approval for chronic kidney disease (CKD) associated with type 2 diabetes (T2D).
The FINEARTS-HF trial evaluated the efficacy and safety of Kerendia in heart failure patients. The study revealed that while adverse events related to high blood potassium levels (hyperkalemia) were more frequent in the Kerendia group (9.7%) compared to the placebo group (4.2%), these events did not result in hospitalizations or deaths, and rarely led to discontinuation of the drug. This is clinically significant, as hyperkalemia is a known risk associated with traditional MRAs.
Current Landscape of Heart Failure Treatment
Heart failure affects over 64 million people globally, and this number is projected to increase. Congestive heart failure arises when the heart's pumping capacity is compromised, leading to blood backflow and fluid accumulation in various organs, including the lungs. Current management strategies involve multiple drug classes targeting different mechanisms involved in heart failure pathophysiology. Mineralocorticoid receptor antagonists (MRAs) are one such class, but conventional MRAs like spironolactone have not consistently demonstrated a reduction in heart failure-related hospitalizations.
Kerendia's Novel Mechanism of Action
Kerendia's mechanism of action involves selectively binding to mineralocorticoid receptors (MRs), preventing fluid buildup. In heart failure, the body activates compensatory mechanisms to increase blood pressure, including MR activation, which promotes salt and water retention. Kerendia, by blocking MRs, counteracts this process and is also thought to reduce scarring of the heart. Kerendia stands out as the first MRA to show evidence of a significantly lower rate of total worsening HF events and death from cardiovascular causes.
Company Information
Bayer is a multinational pharmaceutical and biotechnology company with a diverse portfolio spanning pharmaceuticals, consumer health products, agricultural chemicals, and biotechnology products. Its well-known products include Aspirin, Xarelto, Mirena, and Adalat. Bayer's drug development pipeline includes over 31 products in various clinical trial phases, targeting cardiovascular diseases and oncology, including Darolutamide, a phase 3 clinical trial drug for prostate cancer.
