The drug finerenone has demonstrated a positive impact on patients with type 1 diabetes and chronic kidney disease. By reducing protein excretion in urine, the drug indicates a reduction in kidney damage, thus offering a protective effect on kidney function. Clinical pharmacologist Hiddo Lambers Heerspink from the University Medical Center Groningen (UMCG) spearheaded an extensive international study on this drug’s efficacy. He is set to present the initial findings at the American Society of Nephrology conference in Houston on 6 November.
In recent years, numerous new treatments have emerged for kidney disease in patients with type 2 diabetes. However, patients with type 1 diabetes have largely been excluded from such studies due to potential side effects, resulting in their kidney disease being treated with decades-old blood pressure-lowering drugs. Finerenone is now positioned as the first new, effective, and safe drug for this group in over 30 years. Expectations are high that it will soon be incorporated into treatment guidelines for type 1 diabetes.
Research by Heerspink previously identified protein loss in urine, or albuminuria, as the most reliable early indicator of kidney protection. Traditional endpoints such as dialysis onset and kidney transplantation manifest later and necessitate extensive, long-term studies. With fewer type 1 diabetes patients suffering from kidney disease compared to type 2, traditional drug studies are impractical. Heerspink’s team, therefore, focused on the impact of finerenone on protein excretion.
The study examined finerenone’s mechanism of blocking the aldosterone hormone receptor, which is responsible for regulating salt and water balance and maintaining blood pressure. Prior evidence showed its efficacy in patients with type 2 diabetes by slowing kidney function decline and offering cardiac protection. Heerspink’s study included 242 patients with type 1 diabetes and chronic kidney disease, monitored over six months. Results showed a reduction in urine protein levels by about 25%, suggesting a potential decrease in kidney failure incidence. The drug was generally well tolerated, with only slightly elevated potassium levels noted.
The research involved 82 hospitals across Asia, Europe, and North America. Heerspink asserts that the study’s outcomes bring hope for type 1 diabetes patients and motivate further research into new medications for those at high risk of kidney and heart diseases.
For more information, see the University Medical Center Groningen’s official release.
