Finerenone in patients across the spectrum of chronic kidney disease and type 2 diabetes by glucagon‐like peptide‐1 receptor agonist use
Authors' conclusion
The cardiorenal benefits of finerenone on composite cardiovascular and kidney outcomes and UACR reduction in patients with CKD and T2D appear to be maintained, regardless of GLP-1RA use. Subsequent studies are needed to investigate any potential benefit of this combination.
Study context
- Population
- Patients with T2D and chronic kidney disease (CKD) on optimized renin-angiotensin system blockade; 944 (7.2%) used GLP-1 RAs at baseline944 with GLP-1 RA
- Participants
- 13,026 patients
- Comparison
- Finerenone vs placebo, by baseline GLP-1 RA use
Methodological detailspooled analysis, subgroup analysis by baseline GLP-1 RA use
- Pooled analysis
- Subgroup analysis by baseline GLP-1 RA use
Primary result
As reported in the abstract
Cardiovascular composite (CV death, nonfatal MI, nonfatal stroke or hospitalization for HF) by GLP-1 RA use
Finerenone vs PlaceboHazard ratio (95% CI)P value
With GLP-1 RA
0.76(0.52–1.11)
Without GLP-1 RA
0.87(0.79–0.96)
P = 0.63for interactionFurther findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Kidney composite (kidney failure, sustained ≥57% eGFR decline or renal death) by GLP-1 RA useFinerenonevs PlaceboWith GLP-1 RA | 0.82 (0.45–1.48) | ||
| Kidney composite (kidney failure, sustained ≥57% eGFR decline or renal death) by GLP-1 RA useFinerenonevs PlaceboWithout GLP-1 RA | 0.77 (0.67–0.89) | P for interaction = 0.79 | |
| 0.512Hazard ratio (log scale) |
Urine albumin-to-creatinine ratio (UACR) reduction with finerenone by GLP-1 RA use · Month 4
- With baseline GLP-1 RA use
- −38%
- Without GLP-1 RA use
- −31%
- P-interaction
- P for interaction = 0.03
Safety
- Overall safety and incidence of hyperkalaemia were similar, irrespective of GLP-1 RA use
Original publication
Finerenone in patients across the spectrum of chronic kidney disease and type 2 diabetes by glucagon‐like peptide‐1 receptor agonist use. Diabetes Obes Metab. Published 2 November 2022. doi:10.
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