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Non-steroidal Mineralocorticoid Receptor Antagonists in Cardiorenal Disease by Arjun K Pandey; Deepak L Bhatt; Francesco Cosentino; Nikolaus Marx; Ori Rotstein; Bertram Pitt; Ambarish Pandey; Javed Butler; Subodh Verma is a Medicine article available to read on EtoBox.

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Despite existing treatments, patients with heart failure and chronic kidney disease (CKD) remain at high risk for adverse outcomes and progression to end-stage disease. Steroidal mineralocorticoid receptor antagonists (MRAs) such as spironolactone and eplerenone reduce mortality but remain under-prescribed due to the perceived risk of hyperkalaemia and hormonal side effects. The discovery of non-steroidal MRAs represents a major new dimension in cardiorenal disease therapy. Non-steroidal MRAs have high affinity and specificity for the mineralocorticoid receptor (MR) and differ from both steroidal agents and each other with respect to important physiochemical, pharmacodynamic, and pharmacokinetic parameters. Similar to their steroidal counterparts, they have beneficial anti-inflammatory, anti-remodelling, and anti-fibrotic properties in the kidneys, heart, and vasculature. There are several non-steroidal MRAs under development and clinical assessment; of these, only esaxerenone and finerenone are approved for treatment globally. In Japan, esaxerenone is approved for essential hypertension and has been studied in diabetic nephropathy. Compared with steroidal MRAs, finerenone more pot

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Author

Arjun K Pandey; Deepak L Bhatt; Francesco Cosentino; Nikolaus Marx; Ori Rotstein; Bertram Pitt; Ambarish Pandey; Javed Butler; Subodh Verma

Published

2022

Language

EN

Field

Medicine (Health Sciences)