What are the indications for ertugliflozin in the treatment of type 2 diabetes mellitus (DM), and what are the indications for finerenone?

Updated: Sep 27, 2021
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Indicated as an adjunct to diet and exercise, ertugliflozin therapy is aimed at improving glycemic control in adults with type 2 diabetes. Ertugliflozin's approval stemmed from a series of nine phase-3 clinical trials in which statistically significant improvements were seen in HbA1c, fasting plasma glucose, body weight, and systolic and diastolic blood pressures, in adult patients with type 2 diabetes. [257, 258, 259]

Nonsteroidal mineralocorticoid receptor antagonists

In July 2021, the FDA approved finerenone (Kerendia) for inhibition of the effects in adults of chronic kidney disease associated with type 2 diabetes, including sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure. It is the first nonsteroidal mineralocorticoid receptor (MR) antagonist to be approved for this purpose. Approval was based on the FIDELIO-DKD trial, a placebo-controlled study that involved over 5700 patients with type 2 diabetes to whom the maximum-tolerated dose of renin-angiotensin system inhibitor (RASI) was already being administered. However, until more data on finerenone is gathered, RASIs and SGLT-2 inhibitors will be the preferred agents for slowing chronic kidney disease in type 2 diabetes. [260, 261, 262]


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