Announcement • 12h
Bayer Announces Phase III FIND-CKD Results For KERENDIA In Non-Diabetic Chronic Kidney Disease
Bayer announced full results from the Phase III FIND-CKD trial investigating KERENDIA (finerenone) in adults with non-diabetic chronic kidney disease (nd-CKD) who were also receiving background standard of care. In the trial, KERENDIA met the primary endpoint by showing a significant reduction in the rate of kidney disease progression, as measured by estimated glomerular filtration rate (eGFR) slope (mean annual change from baseline to month 32), compared with placebo. KERENDIA also showed a statistically significant reduction in the risk of a secondary composite kidney-cardiovascular endpoint, which included kidney failure, sustained eGFR decrease =57%, hospitalization for heart failure, or cardiovascular death, versus placebo. KERENDIA met the primary endpoint by showing a significant reduction in the rate of kidney disease progression, as measured by eGFR slope (mean annual change from baseline to month 32), compared with placebo. KERENDIA also showed a statistically significant reduction in the risk of a secondary composite kidney-cardiovascular endpoint, which included kidney failure, sustained eGFR decrease =57%, hospitalization for heart failure, or cardiovascular death, versus placebo. The safety profile of KERENDIA was consistent with prior Phase III studies. The incidence of serious adverse events was similar between the KERENDIA and placebo groups (20.9% and 21.2%, respectively). FIND-CKD is a multicenter, double-blind, Phase III trial investigating KERENDIA versus placebo in 1,584 adults with nd-CKD including etiologies such as hypertension and chronic glomerulonephritis (inflammation of the kidneys’ blood filters). Participants were randomized to receive either KERENDIA or placebo in addition to standard of care, which included maximally tolerated labeled doses of an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB). KERENDIA met the primary efficacy endpoint by showing a statistically significant improvement in eGFR slope compared with placebo. The mean annual rate of eGFR decline from baseline to month 32 was -3.3 mL/min/1.73 m²/year with KERENDIA and -4.0 mL/min/1.73 m²/year with placebo, corresponding to a between-group difference of 0.7 mL/min/1.73 m²/year (95% CI, 0.3 to 1.1; p<0.001). eGFR slope is a validated surrogate endpoint for kidney disease progression. As a key secondary endpoint, KERENDIA showed a statistically significant reduction in the risk of a prespecified composite kidney-cardiovascular outcome compared with placebo (hazard ratio 0.77; 95% CI, 0.60 to 0.99; p=0.043). The composite outcome included kidney failure, sustained eGFR decrease =57%, hospitalization for heart failure, or cardiovascular death. Additionally, in an exploratory analysis, a greater proportion of participants receiving KERENDIA achieved a =30% reduction from baseline in urine albumin-to-creatinine ratio (UACR) at month 6 compared with placebo (56.0% vs 24.4%; odds ratio 3.99; 95% CI, 3.22 to 4.95). The incidence rate of treatment-emergent adverse events (TEAEs) was 68.3% with KERENDIA and 65.4% with placebo. The rate of treatment-emergent serious adverse events (TESAEs) was 20.9% with KERENDIA and 21.2% with placebo. Hyperkalemia, an adverse event of special interest (AESI), was observed more frequently with KERENDIA (17%) compared to placebo (13.3%). The rate of serious hyperkalemia events and hyperkalemia leading to hospitalization or study discontinuation was low in both groups (<1% and <2%, respectively). A prespecified exploratory analysis of FIND-CKD, simultaneously published in the Journal of the American Medical Association, evaluated the efficacy and safety of KERENDIA in people with investigator-reported glomerular disease etiologies including IgA nephropathy (IgAN), focal segmental glomerulosclerosis (FSGS), membranous nephropathy and membranoproliferative glomerulonephritis (MPGN). In this subanalysis, KERENDIA showed an improvement in eGFR slope compared with placebo across glomerular disease subtypes, with a total eGFR slope difference through month 32 of 0.73 mL/min/1.73 m²/year (95% CI, 0.22 to 1.24). KERENDIA was also associated with improvements in UACR and a lower risk of a prespecified composite kidney outcome of kidney failure or sustained decline in eGFR compared with placebo. The incidence rate of serious adverse events was 19.5% with KERENDIA and 21.4% with placebo, while the rate of serious hyperkalemia was 0.9% for both. KERENDIA is a non-steroidal mineralocorticoid receptor antagonist (nsMRA) that selectively and potently blocks mineralocorticoid receptor overactivation in the heart and kidneys. KERENDIA (finerenone) is indicated to reduce the risk of: sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D) (10mg, 20mg tablets); cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adult patients with heart failure with left ventricular ejection fraction (HF LVEF) =40% (10mg, 20mg, 40mg tablets). KERENDIA can cause hyperkalemia. The risk for developing hyperkalemia increases with decreasing kidney function and is greater in patients with higher baseline potassium levels or other risk factors for hyperkalemia. Measure serum potassium and eGFR in all patients before initiation of treatment with KERENDIA and dose accordingly. Do not initiate KERENDIA if serum potassium is >5 mEq/L. Measure serum potassium periodically during treatment with KERENDIA and adjust dose accordingly. More frequent monitoring may be necessary for patients at risk for hyperkalemia, including those on concomitant medications that impair potassium excretion or increase serum potassium. KERENDIA can cause worsening of renal function in patients with heart failure. Rarely, severe events associated with worsening renal function, including events requiring hospitalization, have been observed. Measure eGFR in all patients before initiation of treatment or with dose titration of KERENDIA and dose accordingly. Initiation of KERENDIA in patients with heart failure and an eGFR <25 mL/min/1.73 m2 is not recommended. Measure eGFR periodically during maintenance treatment with KERENDIA in patients with heart failure. Consider delaying up-titration or interrupting treatment with KERENDIA in patients who develop clinically significant worsening of renal function. From the pooled data of FIDELIO-DKD and FIGARO-DKD, the adverse reactions reported in =1% of patients on KERENDIA and more frequently than placebo were hyperkalemia (14% vs 6.9%), hypotension (4.6% vs 3%), and hyponatremia (1.3% vs 0.7%).