Excessive MR activation is implicated in the pathogenesis of cardiovascular disease. MR antagonists (MRA) are effective and key guideline-directed therapy in patients with heart failure (HF) with reduced ejection fraction. However, clinical adverse events due to hyperkalaemia and a decline in renal function significantly restricts the treatment. AZD9977 is a novel, non-steroidal selective MR modulator that, compared with MRA, displays a differentiated MR-binding pattern and cofactor recruitment profile, and exerts similar organ protective effects to eplerenone with minimal effects on urinary electrolyte handling.
