MRA DSA

Mineralocorticoid receptor antagonists (MRAs) are a drug class that have been used in the management of resistant hypertension and heart failure for years. Within the last decade, they have also been identified as a drug class that substantially reduces the risk of kidney failure and albuminuria. Large clinical trials have shown that MRAs, especially non-steroidal MRAs improve kidney and cardiovascular outcomes in individuals with CKD, with a reduction in cardiac and kidney risk of about 20% [1, 2].

Finerenone, a selective non-steroidal MRA, has been approved by regulatory authorities worldwide to treat CKD in patients with type 2 diabetes. The finerenone trials that led to these approvals were conducted prior to recent updates in guideline recommendations for the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) in CKD. The MRA DSA of CAPTIVATE aims to evaluate if finerenone has beneficial effects in patients with CKD when used on top of standard of care treatment which now typically includes SGLT2i. CAPTIVATE includes participants with CKD regardless of diabetes status. As additional domains are added to the CAPTIVATE trial, the effects of finerenone in combination with other promising therapeutic treatments for CKD will also be studied.