[非奈酮和心肾保护:从对照临床试验到现实生活中的临床实践]。

Revue medicale de Liege Pub Date : 2024-11-01
Jean-Christophe Philips, Régis Radermecker, André Scheen
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引用次数: 0

摘要

非格列奈是一种选择性非甾体类矿物质皮质激素受体拮抗剂。在两项大型随机对照试验(FIDELIO-DKD 和 FIGARO-DKD)中,该分子与安慰剂相比,能明显降低 2 型糖尿病(T2D)和慢性肾病患者的心血管发病率和死亡率,并减缓肾病的进展。最近的数据提供了更多信息,说明该分子在患有或未患有 T2D 并伴有心力衰竭的患者(FINEARTS-HF)中的疗效和安全性。在对照试验中获得的这些结果正在现实生活观察研究(FINE-REAL)和其他一些专门针对心力衰竭的研究中得到证实。此外,非格列酮目前还在 T2D 以外的各种特殊人群中进行测试。肾脏病学、心脏病学和糖尿病学方面的一些国际建议都支持在被认为具有较高或极高心血管和肾脏风险的 T2D 患者中使用非格列酮。
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[Finerenone and cardiorenal protection : from controlled clinical trials to real-life clinical practice].

Finerenone is a selective non-steroidal antagonist of the mineralocorticoid receptor. This molecule significantly reduces cardiovascular morbidity and mortality and slows the progression of kidney disease in people with type 2 diabetes (T2D) and chronic kidney disease as demonstrated in two huge randomised controlled trials versus placebo (FIDELIO-DKD and FIGARO-DKD). Recent data provide additional information about both the efficacy and safety of this molecule in patients with or without T2D presenting heart failure (FINEARTS-HF). These results obtained in controlled trials are being confirmed in observational real-life studies (FINE-REAL) and several other studies devoted to heart failure. Also, finerenone is currently being tested among various special populations outside T2D. Several international recommendations in nephrology, cardiology, and diabetology support the use of finerenone in patients with T2D considered at high and very high cardiovascular and renal risk.

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