Peter Kolkhof

Bio: Peter Kolkhof is an academic researcher from Bayer HealthCare Pharmaceuticals. The author has contributed to research in topics: Mineralocorticoid receptor & Medicine. The author has an hindex of 18, co-authored 85 publications receiving 1975 citations. Previous affiliations of Peter Kolkhof include Bayer Corporation & Bayer.

Safety and tolerability of the novel non-steroidal mineralocorticoid receptor antagonist BAY 94-8862 in patients with chronic heart failure and mild or moderate chronic kidney disease: a randomized, double-blind trial

Abstract: Aims Mineralocorticoid receptor antagonists (MRAs) improve outcomes in patients with heart failure and reduced left ventricular ejection fraction (HFrEF), but their use is limited by hyperkalaemia and/or worsening renal function (WRF). BAY 94-8862 is a highly selective and strongly potent non-steroidal MRA. We investigated its safety and tolerability in patients with HFrEF associated with mild or moderate chronic kidney disease (CKD). Methods and results This randomized, controlled, phase II trial consisted of two parts. In part A, the safety and tolerability of oral BAY 94-8862 [2.5, 5, or 10 mg once daily (q.d.)] was assessed in 65 patients with HFrEF and mild CKD. In part B, BAY 94-8862 (2.5, 5, or 10 mg q.d., or 5 mg twice daily) was compared with placebo and open-label spironolactone (25 or 50 mg/day) in 392 patients with HFrEF and moderate CKD. BAY 94-8862 was associated with significantly smaller mean increases in serum potassium concentration than spironolactone (0.04–0.30 and 0.45 mmol/L, respectively, P < 0.0001–0.0107) and lower incidences of hyperkalaemia (5.3 and 12.7%, respectively, P = 0.048) and WRF. BAY 94-8862 decreased the levels of B-type natriuretic peptide (BNP), amino-terminal proBNP, and albuminuria at least as much as spironolactone. Adverse events related to BAY 94-8862 were infrequent and mostly mild. Conclusion In patients with HFrEF and moderate CKD, BAY 94-8862 5–10 mg/day was at least as effective as spironolactone 25 or 50 mg/day in decreasing biomarkers of haemodynamic stress, but it was associated with lower incidences of hyperkalaemia and WRF.

A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and/or chronic kidney disease

Abstract: Aims To evaluate oral doses of the non-steroidal mineralocorticoid receptor antagonist finerenone given for 90 days in patients with worsening heart failure and reduced ejection fraction and chronic kidney disease and/or diabetes mellitus. Methods and results Miner Alocorticoid Receptor antagonist Tolerability Study-Heart Failure (ARTS-HF) was a randomized, double-blind, phase 2b multicentre study (ClinicalTrials.gov: [NCT01807221][1]). Of 1286 screened patients, 1066 were randomized. Patients received oral, once-daily finerenone (2.5, 5, 7.5, 10, or 15 mg, uptitrated to 5, 10, 15, 20, or 20 mg, respectively, on Day 30) or eplerenone (25 mg every other day, increased to 25 mg once daily on Day 30, and to 50 mg once daily on Day 60) for 90 days. The primary endpoint was the percentage of individuals with a decrease of >30% in plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) from baseline to Day 90. A key exploratory endpoint was a composite clinical endpoint of death from any cause, cardiovascular hospitalizations, or emergency presentation for worsening HF until Day 90. Mean age ranged from 69.2 to 72.5 years in different treatment groups (standard deviation 9.7–10.6 years). Decreases in NT-proBNP of >30% from baseline occurred in 37.2% of patients in the eplerenone group and 30.9, 32.5, 37.3, 38.8, and 34.2% in the 2.5→5, 5→10, 7.5→15, 10→20, and 15→20 mg finerenone groups, respectively ( P = 0.42–0.88). Except for the 2.5→5 mg finerenone group, the composite clinical endpoint occurred numerically less frequently in finerenone-treated patients compared with eplerenone; this difference reached nominal statistical significance in the 10→20 mg group (hazard ratio 0.56, 95% confidence interval, CI, 0.35; 0.90; nominal P = 0.02), despite the fact that this phase 2 study was not designed to detect statistical significant differences. A potassium level increase to ≥5.6 mmol/L at any time point occurred in 4.3% of patients, with a balanced distribution among all treatment groups. Conclusion Finerenone was well tolerated and induced a 30% or greater decrease in NT-proBNP levels in a similar proportion of patients to eplerenone. The finding of reduced clinical events in the finerenone 10→20 mg group should be further explored in a large outcomes trial. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT01807221&atom=%2Fehj%2F37%2F27%2F2105.atom

Finerenone, a novel selective nonsteroidal mineralocorticoid receptor antagonist protects from rat cardiorenal injury

Abstract: Pharmacological blockade of the mineralocorticoid receptor (MR) ameliorates end-organ damage in chronic heart failure. However, the clinical use of available steroidal MR antagonists is restricted because of concomitant hyperkalemia especially in patients with diminished kidney function. We have recently identified a novel nonsteroidal MR antagonist, finerenone, which uniquely combines potency and selectivity toward MR. Here, we investigated the tissue distribution and chronic cardiorenal end-organ protection of finerenone in comparison to the steroidal MR antagonist, eplerenone, in 2 different preclinical rat disease models. Quantitative whole-body autoradiography revealed that [C]-labeled finerenone equally distributes into rat cardiac and renal tissues. Finerenone treatment prevented deoxycorticosterone acetate-/salt-challenged rats from functional as well as structural heart and kidney damage at dosages not reducing systemic blood pressure. Finerenone reduced cardiac hypertrophy, plasma prohormone of brain natriuretic peptide, and proteinuria more efficiently than eplerenone when comparing equinatriuretic doses. In rats that developed chronic heart failure after coronary artery ligation, finerenone (1 mg·kg·d), but not eplerenone (100 mg·kg·d) improved systolic and diastolic left ventricular function and reduced plasma prohormone of brain natriuretic peptide levels. We conclude that finerenone may offer end-organ protection with a reduced risk of electrolyte disturbances.

Discovery of BAY 94-8862: A Nonsteroidal Antagonist of the Mineralocorticoid Receptor for the Treatment of Cardiorenal Diseases

Abstract: Aldosterone is a hormone that exerts manifold deleterious effects on the kidneys, blood vessels, and heart which can lead to pathophysiological consequences. Inhibition of the mineralocorticoid receptor (MR) is a proven therapeutic concept for the management of associated diseases. Use of the currently marketed MR antagonists spironolactone and eplerenone is restricted, however, due to a lack of selectivity in spironolactone and the lower potency and efficacy of eplerenone. Several pharmaceutical companies have implemented programs to identify drugs that overcome the known liabilities of steroidal MR antagonists. Herein we disclose an extended SAR exploration starting from cyano-1,4-dihydropyridines that were identified by high-throughput screening. Our efforts led to the identification of a dihydronaphthyridine, BAY 94-8862, which is a potent, selective, and orally available nonsteroidal MR antagonist currently under investigation in a clinical phase II trial.

Applications of Palladium-Catalyzed C–N Cross-Coupling Reactions

Abstract: Pd-catalyzed cross-coupling reactions that form C–N bonds have become useful methods to synthesize anilines and aniline derivatives, an important class of compounds throughout chemical research. A key factor in the widespread adoption of these methods has been the continued development of reliable and versatile catalysts that function under operationally simple, user-friendly conditions. This review provides an overview of Pd-catalyzed N-arylation reactions found in both basic and applied chemical research from 2008 to the present. Selected examples of C–N cross-coupling reactions between nine classes of nitrogen-based coupling partners and (pseudo)aryl halides are described for the synthesis of heterocycles, medicinally relevant compounds, natural products, organic materials, and catalysts.

Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes

Abstract: Background Finerenone, a nonsteroidal, selective mineralocorticoid receptor antagonist, reduced albuminuria in short-term trials involving patients with chronic kidney disease (CKD) and ty...

Lipoxygenase and leukotriene pathways: biochemistry, biology, and roles in disease.

Abstract: 4. Biosynthesis of Leukotrienes 5869 4.1. Discovery of the Leukotriene Pathway and a Common Unstable Intermediate 5869 4.2. Conversion of Arachidonic Acid into Leukotriene A4 (LTA4) Is a Two-Step Concerted Reaction Catalyzed by a Single Lipoxygenase 5869 4.3. Structural Elucidation of Slow-Reacting Substance of Anaphylaxis, A Mixture of Leukotrienes 5870 5. Enzymes and Proteins in Leukotriene Biosynthesis 5870 5.1. Cytosolic Phospholipase A2α (cPLA2α) 5870 5.1.1. Molecular Properties and Regulation of cPLA2α 5870 5.1.2. Crystal Structure and Catalytic Mechanism of cPLA2α 5871 5.2. 5-Lipoxygenase (5-LO) 5871 5.2.1. Cellular Expression of 5-LO 5871 5.2.2. Regulation of 5-LO Gene (ALOX5) Transcription 5872 5.2.3. Naturally Occurring Mutations in the Gene Promoter of 5-LO 5872 5.2.4. Allosteric and Post-translational Regulation of 5-LO 5872 5.2.5. Structure function relationships in 5-LO 5872 5.2.6. Crystal Structure of 5-LO 5872 5.3. 5-Lipoxygenase-Activating Protein (FLAP) 5873 5.3.1. FLAP Is Critical for Cellular 5-LO Activity 5873 5.3.2. Effects of FLAP on Leukotriene Production 5873 5.3.3. FLAP Gene (ALOX5AP) and Regulation of Expression 5874 5.3.4. Crystal Structure of FLAP 5874 5.4. LTA4 Hydrolase 5874 5.4.1. LTA4 Hydrolase Is a Substrate-Selective and Suicide-Inactivated Epoxide Hydrolase 5874 5.4.2. LTA4 Hydrolase Is Bifunctional and Belongs to the M1 Family of Zinc Metallopeptidases 5874 5.4.3. LTA4 Hydrolase Cleaves the Chemotactic Pro-Gly-Pro, a Role for the Aminopeptidase Activity during Resolution of Inflammation 5875 5.4.4. Crystal Structure of LTA4 Hydrolase 5875 5.4.5. Mechanism of the Epoxide Hydrolase Reaction 5876 5.4.6. Mechanism of the Aminopeptidase Activity 5876 5.4.7. Two Catalytic Activities Exerted via Specific but Overlapping Active Sites 5877 5.5. LTC4 Synthase 5877 5.5.1. Molecular Properties of LTC4 Synthase 5877 5.5.2. LTC4 Synthase Is a Member of the MAPEG Superfamily of IntegralMembraneProteins 5877 5.5.3. Gene Structure and Regulation of LTC4 Synthase Expression 5877 5.5.4. Crystal Structure of LTC4 Synthase 5877 5.5.5. Catalytic Mechanism of LTC4 Synthase 5878 6. Intracellular Protein Trafficking and Compartmentalization of Leukotriene Biosynthesis 5878 6.1. Translocation of cPLA2α 5878 6.2. Translocation of 5-LO and Association with FLAP on the Nuclear Envelope 5879 6.2.1. 5-LO in the Nucleoplasm 5879 6.2.2. Organization of a Leukotriene Biosynthetic Complex in the Nuclear Membrane 5879 6.3. Leukotriene Biosynthesis in Lipid Bodies and Actions on Extracellular Granules 5879

Cardiorenal Syndrome: Classification, Pathophysiology, Diagnosis, and Treatment Strategies: A Scientific Statement From the American Heart Association.

Abstract: Cardiorenal syndrome encompasses a spectrum of disorders involving both the heart and kidneys in which acute or chronic dysfunction in 1 organ may induce acute or chronic dysfunction in the other organ. It represents the confluence of heart-kidney interactions across several interfaces. These include the hemodynamic cross-talk between the failing heart and the response of the kidneys and vice versa, as well as alterations in neurohormonal markers and inflammatory molecular signatures characteristic of its clinical phenotypes. The mission of this scientific statement is to describe the epidemiology and pathogenesis of cardiorenal syndrome in the context of the continuously evolving nature of its clinicopathological description over the past decade. It also describes diagnostic and therapeutic strategies applicable to cardiorenal syndrome, summarizes cardiac-kidney interactions in special populations such as patients with diabetes mellitus and kidney transplant recipients, and emphasizes the role of palliative care in patients with cardiorenal syndrome. Finally, it outlines the need for a cardiorenal education track that will guide future cardiorenal trials and integrate the clinical and research needs of this important field in the future.