Effect of Finerenone on Albuminuria in Type 1 Diabetes by Baseline Hemoglobin A1c (HbA1c) Level and Diabetes Duration: An Exploratory Analysis of the FINE-ONE Trial
Authors' conclusion
In adults with type 1 diabetes and CKD, finerenone reduced UACR and was well tolerated irrespective of HbA1c level or diabetes duration.
Study context
- Population
- Adults with T1D and chronic kidney disease (CKD), urinary albumin-to-creatinine ratio (UACR) 200 to <5,000 mg/g, estimated glomerular filtration rate (eGFR) 25 to <90 mL/min/1.73 m²; mean HbA1c 7.6%, diabetes duration 32.0 years, eGFR 58.9 mL/min/1.73 m²HbA1c available for 240
- Participants
- 242 adults
- Comparison
- Finerenone vs placebo, by baseline HbA1c and diabetes duration
- Primary endpoint
- UACR change from baseline by baseline HbA1c and diabetes duration
- Follow-up
- 6 months
Methodological detailsplacebo-controlled, exploratory subgroup analysis
- Placebo-controlled
- Exploratory subgroup analysis
Primary result
As reported in the abstract
Placebo-corrected UACR change by baseline HbA1c tertile
Each group vs placeboEstimate (95% CI)P value
Finerenone
placebo-corrected UACR change, HbA1c <7.1% −17%(−40% to 13%)
Finerenone
placebo-corrected UACR change, HbA1c ≥7.1% to ≤8.1% −18%(−39% to 10%)
Finerenone
placebo-corrected UACR change, HbA1c >8.1% −37%(−55% to −13%)
P = 0.41for interaction- Effects consistent across diabetes duration tertiles
- P for interaction = 0.70
Further findings
| Outcome | Finerenone | Placebo | Placebo-corrected change (95% CI) | P value | |
|---|---|---|---|---|---|
| Median UACR, overall · 6 monthsmg/g | 373.5 | 475.6 | −25% (−35% to −13%) | P = 0.0001 | |
| Baseline | 574.6 | 506.4 | |||
| −40−20020Difference (linear scale) |
%
| Outcome | Finerenone | Placebo | Between-group difference (%) (95% CI) | P value |
|---|---|---|---|---|
| HbA1c change · 6 months | +0.03 (95% CI −0.14%–0.20%) | 0.00 (95% CI −0.12%–0.11%) | +0.04 (−0.17% to 0.24%) | P = 0.74 |
Safety
- Overall safety and incidence of hyperkalemia were similar across HbA1c tertiles
Original publication
Effect of Finerenone on Albuminuria in Type 1 Diabetes by Baseline HbA1c Level and Diabetes Duration: An Exploratory Analysis of the FINE-ONE Trial. Diabetes Care. Published 8 June 2026. doi:10.
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