Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes
Authors' conclusion
Among persons with both chronic kidney disease and type 2 diabetes, initial therapy with finerenone plus empagliflozin led to a greater reduction in the urinary albumin-to-creatinine ratio than either treatment alone.
Study context
- Population
- Adults with CKD (eGFR 30 to 90 ml/min/1.73 m²), albuminuria (urinary albumin-to-creatinine ratio 100 to ≤5000) and T2D, already taking a renin-angiotensin system inhibitor
- Comparison
- Finerenone plus empagliflozin vs finerenone alone vs empagliflozin alone
- Primary endpoint
- Relative change in log-transformed mean urinary albumin-to-creatinine ratio
- Follow-up
- Baseline to 180 days
Methodological details1:1:1 randomisation
- 1:1:1 randomisation
Primary result
As reported in the abstract
Least-squares mean ratio of the difference in the change from baseline
0.71
95% CI 0.61–0.82P < 0.001
Combination therapy vs Finerenone · reduction 29% greater with combination therapy
Least-squares mean ratio of the difference in the change from baseline
0.68
95% CI 0.59–0.79P < 0.001
Combination therapy vs Empagliflozin · reduction 32% greater with combination therapy
Further findings
Baseline urinary albumin-to-creatinine ratio
- Similar among the three groups; median (IQR)
- 579 (292 to 1092)
- Participants with available data: combination therapy / finerenone / empagliflozin
- 265 / 258 / 261
Safety
- Neither agent, alone or in combination, led to unexpected adverse events
- Symptomatic hypotension, acute kidney injury and hyperkalemia leading to drug discontinuation were uncommon
Original publication
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