The role of finerenone in the concomitant management of chronic kidney disease-type 2 diabetes and the implication for heart failure prevention and treatment

Figures

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  Fig. 1. Timeline for finerenone-focused clinical trials in CKD/T2D and in HF. Trials are based on searches completed on clinicaltrials.gov on August 12, 2024. Japan and European/EU clinical trial registers were not searched. The year represents the year of study completion; for preclinical studies, the year represents the year the associated manuscript was published. AKI, acute kidney injury; CKD, chronic kidney disease; CV, cardiovascular; contra, contraindicated; HF, heart failure; HFmrEF, HF with mildly reduced ejection fraction; HFpEF, HF with preserved ejection fraction; HFrEF, HF with reduced ejection fraction; HV, healthy volunteer; IR, ischemia–reperfusion; untol, untolerated; MR, mineralocorticoid receptor; PD, pharmacodynamics; PK, pharmacokinetics; POC, proof of concept; s-MRA, steroidal mineralocorticoid receptor antagonist; T2D, type 2 diabetes

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  Fig. 2. Nonsteroidal MRAs with trials in HF registered on clinicaltrials.gov website (searches performed on August 12, 2024) with completed, planned, or in-progress Phase 2 and/or Phase 3 interventional trials. Trials are presented by ejection fraction. Trials details in orange shade shape represent Phase 2 trials and trials in white shape represents Phase 3 trials. aNot the primary patient population (in FIDELIO-DKD and FIGARO-DKD, the primary patient population, per main inclusion criteria, had CKD associated with T2D; patients with known HFrEF were excluded). CKD, chronic kidney disease; HF, heart failure; HFmrEF, HF with mildly reduced ejection fraction; HFpEF, HF with preserved ejection fraction; HFrEF, HF with reduced ejection fraction; LVEF, left ventricular ejection fraction; NYHA, New York Heart Association

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  Fig. 3. Timeline for clinical development of the ns-MRA balcinrenone (AZD9977) and apararenone (MT-3995). Trials are based on searches completed on clinicaltrials.gov on August 12, 2024. Japan and European/EU clinical trial registers were not searched. “Year” in the figure represents year of study completion. albu, albuminuria; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HF, heart failure; HV, healthy volunteer; impair, impairment; Jap, Japanese; PD, pharmacodynamics; PK, pharmacokinetics; pts, patients; war, warfarin