byUniversity Medical Center Groningen

Credit: Unsplash/CC0 Public Domain

The drug finerenone has a positive effect on patients with type 1 diabetes and chronic kidney disease. The drug reduces the amount of proteins excreted in the urine of these patients. This reduction indicates that the degree of kidney damage is reduced and that the drug has a protective effect on kidney function.

Clinical pharmacologist Hiddo Lambers Heerspink of the UMCG led a large international study into the effect of this drug. He presented the initial results of this study at theAmerican Society of Nephrology conferencein Houston.

Although manynew drugshave been discovered in recent years for the treatment of kidney disease in patients with type 2diabetes, this is not the case for patients with type 1 diabetes. This is mainly because patients with type 1 diabetes were often excluded from participating in studies due to possible side effects.

As a result, kidney disease in people with type 1 diabetes is still treated with blood pressure-lowering drugs dating back to research conducted more than 30 years ago.

Finerenone is now the first new drug in more than 30 years that is effective and safe for this patient group. It is expected that the drug can now be registered in the guidelines for the treatment of type 1 diabetes.

Previous research by Heerspink showed that protein loss in urine (albuminuria) is the best possible indicator of early, measurable kidney protection. The more traditional endpoint in clinical drug studies, such as the onset of dialysis andkidney transplantation, only become apparent at a late stage and require large, long-term studies.

Because there are far fewer patients with type 1 diabetes and kidney disease compared to type 2 diabetes and kidney disease, drug studies with traditional endpoints are practically impossible to conduct. That is why Heerspink and his research team found an alternative and investigated the effect of the drug finerenone on protein excretion.

In the study, Heerspink investigated the effect of the drug finerenone, which blocks the receptor for the hormone aldosterone. Aldosterone is a hormone produced in theadrenal glandsthat regulates salt and water balance to maintain blood pressure.

It had previously been shown that this drug had a positive effect in patients with type 2 diabetes in slowing downkidney functionloss and protecting the heart.

Heerspink investigated whether the drug led to less protein in the urine and whether it was well tolerated in 242 patients with type 1 diabetes andchronic kidney disease.

The patients were followed for six months and the amount of protein in their urine was found to have decreased by about a quarter. This is very likely to translate to less kidney failure in these patients. Finerenone was also safe and well tolerated, except for a slightly elevated potassium level in the blood.

Eighty-two hospitals from nine countries in Asia, Europe and North America participated in the study. According to Heerspink, the results of this study offer hope for patients with type 1 diabetes. At the same time, it encourages researchers to conduct more research into the effect of new medications in these patients at high risk of kidney and heart diseases.

Provided by University Medical Center Groningen