Efficacy and safety of finerenone in the treatment of primary aldosteronism: A prospective clinical study.

AIMS: This study aimed to evaluate the safety and efficacy of finerenone in the treatment of primary aldosteronism (PA).

METHODS

A total of 15 patients with PA were enrolled. The primary endpoint was the proportion of patients achieving normal serum potassium levels without potassium supplementation at the 4-week (4W) follow-up. Secondary endpoints included changes in serum potassium, 24-h urinary potassium, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Serum creatinine, estimated glomerular filtration rate (eGFR), and hyperkalemia incidence were also assessed during follow-ups.

RESULTS

At baseline, all patients had hypokalemia (serum potassium <3.5 mmol/L). At 4W, 47 % (7/15) of patients achieved normal serum potassium without supplementation. Serum potassium levels significantly increased at the 2W, 4W, and 8W follow-ups compared to baseline (all p < 0.05). SBP significantly decreased at the 4W and 8W follow-ups (all p < 0.05), while DBP showed no significant changes. Increases in serum creatinine and decreases in eGFR were observed, particularly in patients with PA and chronic kidney disease (CKD), although these changes were not statistically significant. No instances of hyperkalemia or unexpected safety concerns were reported.

CONCLUSION

Finerenone effectively increased serum potassium levels and reduced SBP in PA, demonstrating its potential as a promising treatment option.