Expert Interview
Discussing Kerendia (finerenone) for the prevention of heart and kidney complications in chronic kidney disease (CKD) associated with type 2 diabetes
Ticker(s): BAYRY, BAYN.XFRAInstitution: University of Chicago
- Professor of Medicine and Director of the ASH Comprehensive Hypertension Center
- Published 700+ peer reviewed articles; current Editor-in-Chief, Am J Nephrology, Editor-in-Chief- Up-to-Date, Nephrology section, Hypertension Section Editor Up-to-Date and Assoc. Ed of Diabetes Care; serves on more than 18 editorial boards including Nephrology, Dialysis & Transplant, Hypertension, J Hypertension and J American Society Hypertension.
- Past-president of the American College of Clinical Pharmacology and the American Society of Hypertension. and former Professor and Vice Chairman of Preventive Medicine and Director of the Rush University
Roughly how many patients with CKD do you currently manage?
Added By: sara_adminWhat has been your experience to date with Kerendia (finerenone)? How many active patients do you have on this drug?
Added By: sara_adminWhat percentage of Diabetics with CKD are on ACEs and ARBs?
Added By: user1ae2bf5fHow much do you use the older MRA drugs like spironolactone and eplerenone in diabetic patients with CKD?
Side effects with these agents?
How frequently do they cause hyperkalemia, and has this limited their use to certain settings, such as in patients without ACEs and ARBs? Do you ever use them in patients on ACEs and ARBs?
Trial data - high level view. clinical utility. How differentiated do you see this drug from mineralocorticoid receptor antagonist class? Is the frequency/severity of hyperkalemia significantly less than caused by those agents?How convincing is the clinical benefit demonstrated?
Composite endpoints & other questions about outcomes
Have you prescribed Kelendia?
Details on that process, have you been able to get it approved?
What specific patients are you intending to use Kerendia in or using it in? Are you looking to use it as a replacement for other MRAs where you use those currently or expand the use of the class to patients on ACEs and ARBs, or both/neither?
In light of new drug classes like SGLT2 inhibitors and many available treatments for diabetics with benefits on blood pressure and outcomes, is there a role for Kerendia and where do you see its opportunity? How does it fit in the treatment landscape. Can that be determined from existing trial data or is more data needed?
Added By: user1ae2bf5fDetails about your practice.
Added By: user1ae2bf5fPlease talk about the management of CKD in Diabetic patients.
Added By: user1ae2bf5fDoes label restriction and required serum potassium monitoring create additional monitoring steps or is this already being checked anyway so not much of an issue?
In terms of serum potassium level requirement <5.0, how many does that exclude?
Contraindications
Concomitant use with strong CYP3A4 inhibitorsPatients with adrenal insufficiency
How common are they in these patients?
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