Finerenone Slows Kidney Function Decline in Non-Diabetic CKD: Phase III FIND-CKD study

The Phase III FIND-CKD trial demonstrated that finerenone (Kerendia™), when added to standard care, significantly reduced the rate of kidney function decline in adults with non-diabetic chronic kidney disease. This was shown by a meaningful improvement in the eGFR slope over 32 months compared to placebo.

The results showed that finerenone reduced kidney function decline by achieving a statistically significant and clinically meaningful improvement versus placebo in addition to standard of care in the estimated glomerular filtration rate (eGFR) slope.

The eGFR slope is a validated surrogate endpoint for clinical kidney outcomes and is used as a predictive metric for the risk of kidney failure. Finerenone was well-tolerated in the FIND-CKD study, which is consistent with the well-established safety profile of finerenone. The clinical data from FIND-CKD will be presented at an upcoming scientific conference, and Bayer plans to submit the data to health authorities to extend the indication of Kerendia™ to this patient population.

Approximately 850 million people worldwide are living with chronic kidney disease (CKD) and more than half of them have non-diabetic CKD. Non-diabetic CKD can have a range of etiologies, of which the most common include hypertension and glomerulonephritis (including immunoglobulin A nephropathy (IgAN)). Chronic kidney disease linked to hypertension is the second most common cause of kidney failure. Worldwide, more than 3.5 million people with kidney failure are treated with dialysis, which is linked to a 5-year survival rate of about 40% after treatment initiation. In addition, patients with advanced non-diabetic CKD face a significantly increased risk for a fatal cardiovascular event, about 2.6 times higher than that of the general population without CKD, which increases further as kidney function declines. Despite the high prevalence and high morbidity and mortality rate, non-diabetic CKD etiologies remain underrepresented in international clinical practice guidelines.

“Patients with non-diabetic chronic kidney disease experience a progressive loss of kidney function and are at high risk of kidney failure and cardiovascular disease. New treatments that can reduce kidney disease progression are needed to help improve the prognosis of these patients, who have a substantial risk for cardiovascular events and kidney failure which can necessitate dialysis,” said Hiddo L. Heerspink, Professor of Clinical Trials and Personalized Medicine, clinical trialist at the Department of Clinical Pharmacy and Pharmacology at the University Medical Center Groningen, Netherlands, and Co-Chair of the study’s Executive Committee. “The FIND-CKD results are encouraging because they show the benefits of finerenone in preserving kidney function in a dedicated study across several etiologies of non-diabetic chronic kidney disease.”

“The positive results of the Phase III FIND-CKD study represent an important advancement in the area of non-diabetic chronic kidney disease, regardless of the underlying cause,” said Dr. Christian Rommel, Global Head of Research and Development at Bayer’s Pharmaceuticals Division. “Combined with the overall evidence from the THUNDERBALL chronic kidney disease clinical trial program including the pivotal studies FIDELIO-DKD, FIGARO-DKD, and FINE-ONE, these results further strengthen the evidence on the consistent benefits of finerenone in the treatment of patients with chronic kidney disease.”

Finerenone is a non-steroidal, selective mineralocorticoid receptor antagonist (nsMRA) and the first drug targeting the mineralocorticoid receptor (MR) pathway that in five pivotal Phase III studies has demonstrated cardiovascular and/or kidney benefits, respectively, in patients with HF with left ventricular ejection fraction (LVEF) ≥40%, patients with CKD associated with type 2 diabetes, patients with CKD associated with type 1 diabetes, and patients with non-diabetic CKD. FIND-CKD is the largest Phase III study to date focused on non-diabetic CKD, and investigated finerenone in a broad patient population spanning different etiologies of non-diabetic CKD, adding to the positive data and breadth of evidence of finerenone in CKD associated with diabetes. Finerenone is already marketed as Kerendia™ or, in selected countries, as Firialta™, and approved for the treatment of adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D) in more than 100 countries worldwide, including in China, Europe, Japan, and the U.S. In the U.S. and in Japan and some other markets, finerenone is also approved for the treatment of heart failure with LVEF ≥ 40%. Applications in HF with LVEF ≥ 40% in additional markets, including China and Europe, are under review.