Key result
MRAs combined with SGLT2 inhibitors and GLP-1 receptor agonists show promise for treating CKM syndrome.
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MRAs, especially when combined with SGLT2 inhibitors and GLP-1 receptor agonists, offer promising therapeutic potential for cardiovascular-kidney-metabolic syndrome, with future directions pointing towards biomarker-guided precision medicine.
Mineralocorticoid receptor antagonists (MRAs) are important pillars in the treatment of heart failure (HF), chronic kidney disease (CKD), and diabetic kidney disease (DKD). MRAs share complementary pathways with sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with cardiovascular-kidney-metabolic (CKM) syndrome. Combination therapies of MRA with SGLT2i and GLP-1RA are showing promising results in CKM than individual therapies. Further, the unique action of MRAs in antagonizing MR receptors and aldosterone, implicated in the pathophysiology of several conditions, is paving the way for clinical trials and promising results in these therapeutic areas. Disease-specific biomarkers such as UACR and eGFR are increasingly being used to individualize treatment with MRA. Utilizing MRA-specific biomarkers may open the path for precision medicine and further treatment individualization.
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Joshi et al. (2026) conducted a review in Heart failure, chronic kidney disease, diabetic kidney disease, and cardiovascular-kidney-metabolic syndrome. Mineralocorticoid receptor antagonists (MRAs) was evaluated. Mineralocorticoid receptor antagonists, particularly in combination with SGLT2 inhibitors and GLP-1 receptor agonists, show promise for treating cardiovascular-kidney-metabolic syndrome.
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