Finerenone Treatment for Diabetic Cardiovascular Autonomic Neuropathy: the FibroCAN Study
Led by Peter Rossing · Updated on 2025-05-25
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Sponsors
P
Peter Rossing
Lead Sponsor
S
Steno Diabetes Center Nordjylland
Collaborating Sponsor
AI-Summary
What this Trial Is About
Researchers are evaluating the potential of finerenone to treat cardiovascular autonomic neuropathy (CAN), a serious complication affecting about 20% of people with type 2 diabetes. CAN increases the risk of heart disease, kidney damage, and death, and this phase 2, double-blind, randomized, placebo-controlled trial aims to better understand if finerenone can improve early-stage CAN and other neuropathies in patients with type 2 diabetes.
Participants will receive either finerenone or a placebo for 78 weeks. The finerenone dosage will be adjusted based on kidney function and potassium levels, starting at 10mg, 20mg, or 40mg daily as tablets taken by mouth. Those with better kidney function start higher and may increase dose if potassium levels allow. The study will compare changes between the finerenone group and the placebo group over this treatment period.
During the trial, participants will attend visits at screening, baseline, and at weeks 12, 24, 36, 52, and 78. Tests will measure heart rate variability, responses to cardiovascular autonomic reflex tests, and fibrosis markers in blood and skin biopsies. Researchers will monitor safety, medication adherence, and neuropathy progression. The study will last about 78 weeks per participant, with ongoing assessments to evaluate finerenone's effects on CAN and related conditions.
CONDITIONS
Brief Title
Finerenone Treatment for Diabetic Cardiovascular Autonomic Neuropathy: the FibroCAN Study
Who Can Participate
Age: 40Years +
All Genders
Eligibility Criteria
You may qualify if you...
Given informed consent
Diagnosed with type 2 diabetes based on WHO criteria
Aged 40 years or older at inclusion
Have a pathological E/I ratio based on cardiovascular autonomic reflex testing (mean of three measures)
You will not qualify if you...
No cardiovascular autonomic neuropathy (normal CARTs)
Definite cardiovascular autonomic neuropathy with more than one abnormal CART
HbA1C greater than 100 mmol/L
Use of potassium-sparing diuretics or mineralocorticoid receptor antagonists that cannot be stopped 4 weeks before screening
Atrial fibrillation or flutter
Congestive heart failure classified as NYHA class 3 or 4
History of cardiac arrhythmia
Severe respiratory diseases including asthma and COPD
Neuropathy from causes other than diabetes
Women of childbearing potential without a negative pregnancy test or not using effective contraception
Severe liver impairment
Lactose intolerance
Breastfeeding
Kidney failure requiring dialysis
Use of beta-blockers
Hyperkalemia at screening (plasma potassium over 4.8 mmol/L)
Treatment with strong CYP3A4 inhibitors or inducers that cannot be stopped 4 weeks before screening
Chemotherapy within the last 12 months
Inability to follow the study protocol or understand Danish
Regular grapefruit consumption that cannot be stopped during the study period
Other medical or logistical reasons assessed by the investigator preventing participation
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Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - 78 weeks
Participants receive either finerenone or placebo tablets orally, with dosage adjustments based on kidney function and potassium levels, over the course of the treatment period.
Protocol for the FibroCAN study: a randomised controlled trial of finerenone treatment for early-stage cardiovascular autonomic neuropathy in type 2 diabetes.
Maria Bitsch Poulsen, Tina Okdahl, Jens Hove Buciek...