Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis

Cardiovascular and Metabolic Risk Sodium 610 3. Good health 03 medical and health sciences Glucose 0302 clinical medicine Diabetes Mellitus, Type 2 Cardiovascular Diseases Humans Diabetic Nephropathies Renal Insufficiency, Chronic
DOI: 10.2337/dc22-0294 Publication Date: 2022-08-16T08:51:58Z
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ABSTRACT
Finerenone reduced the risk of kidney and cardiovascular events in people with chronic disease (CKD) type 2 diabetes FIDELIO-DKD FIGARO-DKD phase 3 studies. Effects finerenone on outcomes patients taking sodium-glucose cotransporter inhibitors (SGLT2is) were evaluated a prespecified pooled analysis these studies.Patients urine albumin-to-creatinine ratio (UACR) ≥30 to ≤5,000 mg/g estimated glomerular filtration rate (eGFR) ≥25 mL/min/1.73 m2 randomly assigned or placebo; SGLT2is permitted at any time. Outcomes included composite (cardiovascular death, nonfatal myocardial infarction, stroke, hospitalization for heart failure) (kidney failure, sustained ≥57% eGFR decline, renal death) end points, changes UACR eGFR, safety outcomes.Among 13,026 patients, 877 (6.7%) received an SGLT2i baseline 1,113 (8.5%) initiated one during trial. For composite, hazard ratios (HRs) 0.87 (95% CI 0.79-0.96) without 0.67 0.42-1.07) SGLT2i. HRs 0.80 0.69-0.92) 0.42 0.16-1.08) Baseline use did not affect reduction composites (Pinteraction = 0.46 0.29, respectively); neither concomitant study treatment.Benefits compared placebo cardiorenal CKD observed irrespective use.
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