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Finerenone induces a unique MR ligand-binding domain conformation, resulting in altered recruitment of transcriptional co-regulators compared with steroidal MRAs.97) This selective MR modulation leads to a more complete repression of pro-inflammatory and pro-fibrotic gene expression, while exerting less residual agonistic activity in epithelial tissues.97) These mechanistic differences provide a plausible biological rationale for the enhanced cardiorenal protection and improved tolerability profile observed with non-steroidal MRAs, including a lower risk of hyperkalaemiaa major barrier to MRA implementation.97, 98, 99) Two phase III trials initially evaluated finerenone in patients with CKD and type 2 diabetes
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Braz J Pharm Sci 55:e18311 Maniaci A, La Via L, Lechien J, Sangiorgio G, Iannella G, Magliulo G, Pace A, Mat Q, Lavalle S, Lentini M (2024) Hearing loss and oxidative stress: a comprehensive review