糖尿病肾病新药-非奈利酮

Chronic kidney disease (CKD) is the most common complication of diabetes, and about 40% of patients with type 2 diabetes will develop CKD. The number of patients with diabetic nephropathy (DN) has been gradually increasing globally in recent years, and the proportion of hospitalizations for patients with diabetes and CKD in my country has also continued to increase. Clinical trials have shown that nonsteroidal mineralocorticoid receptor antagonists (MRA) have a protective effect on renal function and heart in CKD patients with diabetes. It is an analog dihydronaphthyridine compound obtained by structural modification of dihydropyridine calcium channel blockers. Its activity on the mineralocorticoid receptor (MR) is stronger than that of spironolactone and eplerenone, and its selectivity is also higher than that of spironolactone. It is evenly distributed in tissues. Today I will tell you about this new drug for diabetic nephropathy, fenelidone.

The results of the FIDELIO-DKD trial released in 2020 clearly confirmed that fenelinone can significantly reduce the risk of renal and cardiovascular events in patients with chronic kidney disease (CKD) and type 2 diabetes. This is an international multi-center randomized double-blind placebo-controlled parallel phase III clinical trial, which included 5734 patients with CKD and type 2 diabetes from more than 1000 centers in 48 countries. On the basis of standard treatment, they were randomly assigned to receive once-daily oral fenelidone (10 mg or 20 mg) or placebo.

The results of the study showed that compared with placebo, fenelidone significantly reduced the risk of the composite endpoint of first-time renal failure, estimated glomerular filtration rate decline from baseline by more than 40% for at least 4 weeks, and renal death by 18% (HR =0.82; 95CI 0.73~0.93, P=0.001). The urinary albumin/creatinine ratio decreased by 31% at 4 months and continued to remain at a low level thereafter (HR=0. 69;95% CI 0.66~0.71). This randomized controlled trial provides strong evidence that fenelinone reduces the risk of renal events in patients with CKD and type 2 diabetes.

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.