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FLEX-MRA trial

FlEXible use of finerenone and steroidal MRA in patients with heart failure with mildly reduced or preserved ejection fraction and chronic kidney disease - FLEX-MRA

Status
Recruiting
Phases
Unknown
Study type
Interventional
Source
JPRN
Registry ID
JPRN-jRCTs031260070
Enrollment
180
Registered
2026-05-12
Start date
2026-05-12
Completion date
Unknown
Last updated
2026-06-29

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart failure patients complicated by chronic kidney disease

Interventions

Oral administration of finerenone(Kerendia)10 mg or 20 mg once daily for 12 weeks.

Sponsors

Matsumoto Shingo
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: 1) Patients aged greater than or equal to 20 years (male or female) at the time of informed consent. 2) Diagnosis of HF with most recent LVEF greater than or equal to 40% within the past 1 year 3) Outpatients without recent WHF within 4 weeks prior to informed consent (Events including the initiation or up-titration of HF therapies or diuretics.) 4) CKD (eGFR < 60 mL/min/1.73m2) by CKD-EPI Creatinine Equation (2021) within 2 weeks prior to informed consent 5) Spironolactone 25 or 50 mg/day for the management of HF at least 4 weeks at the time of informed consent. 6) For patients in sinus rhythm, NT-proBNP greater than or equal to 300 pg/mL (or BNP greater than or equal to 100 pg/mL) measured within 90 days prior to informed consent is required. These qualifying levels are tripled for patients with atrial fibrillation (i.e., NT-proBNP greater than or equal to 900 pg/mL or BNP greater than or equal to 300 pg/mL). 7) Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol 8) Signed informed consent must be obtained prior to participation in the study

Exclusion criteria

Exclusion criteria: (Exclusion criteria at informed consent) 1) eGFR 5.0 mmol/L 3) Severe hypertension (SBP greater than or equal to 180 mmHg or DBP greater than or equal to 110 mmHg) or hypotension (SBP 5.5 mEq/L at the start of study drug administration -Hepatic insufficiency classified as Child-Pugh C -Addison's disease -Patients with severe renal impairment (eGFR <25 mL/min/1.73 m2) at the start of study drug administration 8) Any other condition or therapy, which would make the participant unsuitable for this study and will not allow participation for the full planned study period (e.g. active malignancy or other condition limiting life expectancy to less than 12 months) 9) Participation in another interventional clinical study (e.g. Phase 1 to 3 clinical studies) or treatment with another investigational medicinal product within 30 days prior to screening (Exclusion criteria during the run-in period (from obtaining informed consent to baseline)) 1)Use of potassium supplements or potassium binders 2)Serum potassium greater than or equal to 6.0 mmol/L 3)Occurrence of serious adverse events requiring hospitalization or out-of-hospital worsening heart failure events at baseline

Design outcomes

Primary

MeasureTime frame
Absolute change in serum potassium levels from baseline (Timepoint 1) to Week 12 after switching to finerenone.

Secondary

MeasureTime frame
1)Incidence of hyperkalemia(serum potassium > 6.5, > 6.0, > 5.5 mmol/L) 2)MRA discontinuation: Discontinuation rate of the study drug (MRA) 3)Changes in NT-proBNP: Absolute and percentage change in NT-proBNP from baseline to Week 12

Contacts

Public ContactFumie Saito

Tokai University Hospital

f.saito@tokai.ac.jp+81-463-93-1121

Outcome results

None listed

Source: JPRN (via WHO ICTRP) · Data processed: Jul 3, 2026