August 21, 2023. Comparing Spironolactone, Epleronone and Finerenone

Article name: Non-steroidal Mineralocorticoid Receptor Antagonism for the Treatment of Cardiovascular and Renal Disease

Link
DOI

This article was published in the European Journal of Heart Failure in 2016. It is a review article.

The article reviews the role of the non-steroidal mineralocorticoid receptor antagonism in the treatment of cardiovascular and renal disease. For the purposes of this post, in page 29, it compares the potency of spironolactone, epleronone and finerenone with respects to the actions on the mineralocticoid receptor (MR), the androgen receptor (AR), the glucocorticoid receptor (GR) and the progesterone receptor (PR).

The article shows that spironolactone, in addition to being a good antagonist of the MR, it also antagonizes the AR receptor causing gynecomastia and impotence in males, and it is an agonist of the PR, causing amenorrhea in menstruating females. Epleronone is much more selective for the MR, but less potent. Finerenone is more selective and more potent for the MR.

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