2022年ADA指南更新：非奈利酮闪亮登场！

Fenelidone appeared on the ADA guideline stage for the first time in 2022 and received the highest level of recommendation. This is based on sufficient evidence-based medical evidence that has emerged in recent years. The disease burden of patients with diabetes mellitus and chronic kidney disease (CKD) is serious, and its treatment has been slow and difficult in the past few years. Even if current standard treatments are applied, patients with T2DM and CKD still have a very high risk of renal disease progression and residual risk of cardiovascular disease. The emergence of T2DM and CKD provides a new and powerful means to break through the existing treatment difficulties.

This randomized, double-blind, placebo-controlled, international multi-center RCT study enrolled 5734 patients with type 2 diabetes and CKD, with an average follow-up of 2.6 years. Compared with placebo treatment, fenelinone treatment can significantly reduce renal endpoint events (renal failure, eGFR exceeding 40% of baseline, or death due to kidney disease) (17.8% vs 21.1%, P=0.001), and the incidence of cardiac endpoint events is also lower than that of the placebo group (13.0% vs placebo group). 14.8%, P=0.03). After 4 months of treatment, the urinary albumin and creatinine in the fenelidone group decreased by 31% compared with the baseline, and persisted. The results confirmed that on the basis of RAS blocker treatment, fenelidone can further reduce the risk of CKD progression and cardiovascular events.

Fennelidone can significantly reduce NT-proBNP levels in patients with chronic heart failure with reduced ejection fraction and renal insufficiency. More importantly, it can simultaneously reduce the incidence of hyperkalemia and worsening of renal function. In addition, in patients with chronic heart failure, type 2 diabetes, and/or chronic kidney disease with reduced ejection fraction, fenelinone and eplerenone have the same effect and can significantly reduce the levels of NT-proBNP, but they can also moderately reduce the patient's mortality rate and cardiovascular hospitalization rate.

Note: The above information comes from the Internet and is compiled and edited by Medical Companion Travel (please correct me if there are any errors or omissions). It is only to provide information on the latest drugs on the market in the world and help Chinese patients understand the latest international new drug trends. It is only for internal discussion among medical staff and does not serve as any basis for medication. For specific medication guidelines, please consult the attending physician.