Use of Kerendia (Finerenone), MOA and side effects

All about Kerendia (Finerenone), from its MOA to side effects is touched upon in this ppt including researches and statistics.

1. KERENDIA
(Finerenone)
Safa Jehangir Khamisa

2. CONTENTS OF THIS PRESENTATION
1. Indications
2. Disease Overview
3. Mechanism of Action
4. Administration
5. Warnings
6. Patient resources
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3. KERENDIA is a prescription medicine used to treat chronic
kidney disease in adults with type 2 diabetes to reduce the
risk of:
Worsening of kidney disease.
Kidney failure.
Death due to cardiovascular disease.
Heart attack.
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4. Indications
Kerendia is a prescription medicine used in adults with chronic kidney disease
with associated type 2 diabetes to reduce the risk of:
❑Worsening of the kidney function
❑Kidney failure
❑Death due to cardiovascular disease
❑Heart attack
❑Hospitalization for heart failure
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5. Clinical Data
In the renal outcomes trial
(FIDELIO-DKD) of adult patients
with CKD associated with T2D

6. Kerendia significantly slowed CKD progression in addition to an
ACEi or ARB. The treatment effect reflected a reduction in a
sustained decline in eGFR of > 40% and progression to kidney failure,
or renal death.
In the CV outcomes trial (FIGARO-DKD) the treatment effect
reflected a reduction of CV death, non-fatal MI, and hospitalization
for HF.
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7. CKD
Kidney damage for ≥ 3 months as defined by: structural or functional abnormality
of kidney with or without decreased GFR manifested by either pathologic
abnormalities in composition of blood or urine or abnormalities in imaging tests
OR:
GFR <60 ml/min/1.73m2 for 3 months with or without kidney damage
Albuminuria :
Albuminuria refers to abnormal loss of albumin in urine Albumin is one type of
plasma protein in urine in normal subjects and in larger quantity in patients with
kidney damage
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8. Classification of Albuminuria
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Category Amount of albumin excreted
A1: Normal to mildly increased <30 mg/day (or mg/g)
A2: Moderately increased 30-300mg/day (or mg/g)
A3: Severely increased >300 mg/dl (or mg/g)
Nephrotic Syndrome >2,200 mg/day ( or mg/g)

9. Mechanism of Action
Kerendia is a first-in-class nonsteroidal Mineralocorticoid
(Aldosterone) Receptor antagonist that blocks MR
overactivation; in tissues such as kidneys, heart, and blood
vessels.
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10. Dosage and administration:
Kerendia is available as film-coated tablets and available in
two strengths: 10 mg, 20 mg. Prior to Initiation of Kerendia
check serum potassium levels and estimated GFR, do not start
the treatment if serum potassium is >5 mEq/L.
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11. Recommended Starting Dose:
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12. Dose adjustment based on current serum
potassium levels and current dose:
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Missed doses:If a dose is missed, administer as soon as
possible but only on the same day. If not possible, skip the
dose and continue with the next dose as scheduled.

13. Drug Interactions
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Strong CYP3A4 inhibitor
Concomitant use of Kerendia with Strong CYP3A4 is contradicted.
Moderate & weak CYP3A4 Inhibitors
Monitor serum potassium during drug initiation or dosage adjustment of
either Kerendia or weak CYP3A4i and adjust Kerendia dosage
Strong and Moderate CYP3A4 inducers
Avoid concomitant use of Kerendia with strong or moderate CYP3A4
inducers
Food Interaction: Avoid concomitant use with
grapefruit or grapefruit juice.

14. Adverse Effects:
In FDA trials:
•Most common: hyperkalemia, hypotension, hyponatremia
•Serious adverse reactions occurred in 32% of patients receiving Kerendia and in
34% of patients receiving placebo. Permanent discontinuation due to adverse
reactions occurred in 7% of patients receiving Kerendia and in 6% of patients
receiving placebo. Hyperkalemia led to permanent discontinuation of treatment
in 2.3% of patients receiving Kerendia versus 0.9% patients receiving placebo
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15. Warnings And Precautions
HYPERKALEMIA:
•Kerendia can cause hyperkalemia. The risk for developing
hyperkalemia increases with decreasing kidney function
•Do not initiate Kerendia if serum potassium is >5 mEq/L
•Measure serum potassium periodically during treatment
with Kerendia and adjust dose accordingly
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16. Contraindications
Concomitant use with strong CYP3A4 inhibitors
Patients with adrenal insufficiency
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17. Sources
Bakris GL, Agarwal R, Anker SD, Pitt B, Ruilope LM, Rossing P, Kolkhof P, Nowack C, Schloemer P, Joseph A, Filippatos G;
FIDELIO-DKD Investigators. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med.
2020 Dec 3;383(23):2219-2229. doi: 10.1056/NEJMoa2025845. Epub 2020 Oct 23. PMID: 33264825.
KDIGO – kidney disease | improving global outcomes.
https://kdigo.org/wpcontent/uploads/2017/02/KDIGO_2012_CKD_GL.pdf. Accessed February 8, 2023.
Kerendia prescribing information - labeling.bayerhealthcare.com.
https://labeling.bayerhealthcare.com/html/products/pi/Kerendia_PI.pdf. Accessed February 8, 2023.
Kerendia® (finerenone): Healthcare Professionals (HCP). KERENDIA® (finerenone) | Healthcare Professionals (HCP).
https://www.kerendiahcp.com/. Accessed February 8, 2023.
Rico-Mesa JS, White A, Ahmadian-Tehrani A, Anderson AS. Mineralocorticoid Receptor Antagonists: a Comprehensive
Review of Finerenone. Curr Cardiol Rep. 2020 Sep 10;22(11):140. doi: 10.1007/s11886- 020-01399-7. PMID: 32910349.
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18. Thank you