Werkzaamheid en veiligheid van finerenon bij primair aldosteronisme

BACKGROUND:Finerenone is a novel nonsteroidal mineralocorticoid receptor antagonist. However, robust evidence about its efficacy and safety in primary aldosteronism is scarce.METHODS:In this prospective, multicenter, single-arm, and exploratory trial, we enrolled adults (aged ≤75 years) with primary aldosteronism, an office blood pressure (BP) ranging from 140 to 180/90 to 120 mm Hg, and an estimated glomerular filtration rate ≥60 mL/min per 1.73 m². Eligible patients received finerenone (20–40 mg/d) treatment for 12 weeks. The primary outcome was the change in daytime systolic BP at 12 weeks.RESULTS:Fifty-seven patients were ultimately treated. Per-protocol analysis revealed that finerenone treatment significantly reduced mean daytime systolic BP (−6.69±1.60 mm Hg;P<0.001) and diastolic BP (−4.55±1.06 mm Hg;P<0.001) according to ambulatory monitoring. Mean office BP decreased even more substantially (systolic BP, −15.58±1.69 mm Hg; diastolic BP, −8.61±1.02 mm Hg; bothP&a