Adding Finerenone to SGLT2 Inhibitors and Long‐Term Kidney Outcomes in Diabetic Kidney Disease
Authors' conclusion
Among patients with DKD receiving RASi and SGLT2i therapy, the addition of finerenone was associated with greater proteinuria reduction and a significant improvement in the post-initial dip eGFR slope, suggesting that TCT may offer an additional renoprotective strategy in DKD.
Study context
- Population
- Patients with diabetic kidney disease (DKD) receiving combined RASi and SGLT2i therapyITT analysis
- Participants
- 255 patients
- Exposure
- Finerenone added to RASi + SGLT2i vs RASi + SGLT2i alone
- Outcome
- Longitudinal changes in proteinuria, serum potassium and eGFR slope (total eGFR slope over 24 months; post-initial dip eGFR slope from 3 to 24 months)
- Follow-up
- 24 months
Methodological detailspropensity-score matched
- Propensity-score matched
Main finding
As reported in the abstract
Reduction in proteinuria
47%
P = 0.028
at 24 months
Attenuation of annual estimated glomerular filtration rate (eGFR) decline (post-initial dip slope)
1.31 mL/min/1.73 m²/year
95% CI 0.25–2.36P = 0.015
approximately
Between-group difference (post-initial dip slope, after propensity score (PS) matching)
1.45 mL/min/1.73 m²/year
95% CI 0.32–2.58P = 0.012
after PS matching
Observational data: associations, not effects.
Safety
- Serum potassium increased modestly early in triple combination therapy (TCT) but stabilised thereafter, with no significant difference between groups at 24 months
Original publication
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