A comprehensive examination and analysis of the effectiveness and safety of finerenone for the treatment of diabetic kidney disease: a systematic review and meta-analysis.

IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Frontiers in Endocrinology Pub Date : 2024-12-20 eCollection Date: 2024-01-01 DOI:10.3389/fendo.2024.1461754
Jianyu Chen, Jisu Xue, Jiahui Chen, Tingfei Xie, Xiaolu Sui, Yanzi Zhang, Aisha Zhang, Yunpeng Xu, Jihong Chen
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Abstract

Objectives: The study will evaluate the effectiveness and safety of finerenone in patients diagnosed with diabetic kidney disease (DKD).

Methods: Various databases including PubMed, Sinomed, Web of Science, Embase, Clinical Trials, and Cochrane Library were systematically reviewed for pertinent studies published from the beginning to February 2024.This meta-analysis utilized RevMan 5.3 and Stata 15.1.

Results: The analysis of 4 randomized controlled trials involving 13,943 participants found that finerenone treatment significantly decreased the urine albumin-to-creatinine ratio compared to placebo. Additionally, the risk of COVID-19, cardiovascular events, and estimated glomerular filtration rate(eGFR) reduction of at least 40% were all significantly lower in the finerenone treatment group. However, the finerenone group did experience higher baseline increases in serum potassium levels. The meta-analysis revealed that there was no variation in the likelihood of general negative outcomes (RR 1.00, 95% CI 0.98, 1.01, I2 = 0%) and the occurrence of cancers (RR 0.99, 95% CI 0.83, 1.18,I2 = 0%) among the two categories.

Conclusion: Our study demonstrates that finerenone has the potential to lower the chances of end-stage kidney disease, renal failure and cardiovascular mortality in individuals with diabetic kidney disease. It is important to monitor for hyperkalemia risk. The administration of finelidone among individuals with diabetic kidney disease may potentially mitigate the susceptibility to contracting COVID-19.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024536612.

芬尼酮治疗糖尿病肾病的有效性和安全性的综合检查和分析:系统回顾和荟萃分析。
目的:本研究将评估芬烯酮在糖尿病肾病(DKD)患者中的有效性和安全性。方法:系统检索PubMed、Sinomed、Web of Science、Embase、Clinical Trials、Cochrane Library等数据库自年初至2024年2月发表的相关研究。本meta分析采用RevMan 5.3和Stata 15.1。结果:对4项随机对照试验的分析,涉及13943名参与者发现,与安慰剂相比,芬纳酮治疗显著降低了尿白蛋白与肌酐比率。此外,细芬烯酮治疗组的COVID-19风险、心血管事件和估计肾小球滤过率(eGFR)降低至少40%均显著降低。然而,芬烯酮组的血清钾水平确实有较高的基线升高。荟萃分析显示,两类患者一般不良结局的可能性(RR 1.00, 95% CI 0.98, 1.01, I2 = 0%)和癌症发生的可能性(RR 0.99, 95% CI 0.83, 1.18,I2 = 0%)均无差异。结论:我们的研究表明,芬烯酮具有降低糖尿病肾病患者终末期肾病、肾功能衰竭和心血管疾病死亡率的潜力。监测高钾血症风险很重要。糖尿病肾病患者服用非利酮可能会降低感染COVID-19的易感性。系统综述注册:https://www.crd.york.ac.uk/prospero/,标识符CRD42024536612。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Frontiers in Endocrinology
Frontiers in Endocrinology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
5.70
自引率
9.60%
发文量
3023
审稿时长
14 weeks
期刊介绍: Frontiers in Endocrinology is a field journal of the "Frontiers in" journal series. In today’s world, endocrinology is becoming increasingly important as it underlies many of the challenges societies face - from obesity and diabetes to reproduction, population control and aging. Endocrinology covers a broad field from basic molecular and cellular communication through to clinical care and some of the most crucial public health issues. The journal, thus, welcomes outstanding contributions in any domain of endocrinology. Frontiers in Endocrinology publishes articles on the most outstanding discoveries across a wide research spectrum of Endocrinology. The mission of Frontiers in Endocrinology is to bring all relevant Endocrinology areas together on a single platform.
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