Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance
Authors' conclusion
Insulin resistance was associated with increased cardiovascular (but not kidney) risk and did not modify finerenone efficacy.
Study context
- Population
- Patients with T2D and CKD (urine albumin-to-creatinine ratio (UACR) ≥30 to <300 mg/g and estimated glomerular filtration rate (eGFR) ≥25 to ≤90 mL/min/1.73 m², or UACR ≥300 to ≤5,000 mg/g and eGFR ≥25 mL/min/1.73 m²) on optimized renin-angiotensin system blockade; Estimated glucose disposal rate (eGDR) calculated for 12,964eGDR for 12,964
- Participants
- 13,026 patients
- Comparison
- Finerenone vs placebo by baseline insulin resistance
Methodological detailssubgroup analysis by baseline eGDR
- Subgroup analysis by baseline eGDR
Primary result
As reported in the abstract
Finerenone vs PlaceboHazard ratio (95% CI)P value
Cardiovascular, eGDR <median (insulin resistant)
0.81(0.72–0.92)
Cardiovascular, eGDR ≥median (insulin sensitive)
0.92(0.79–1.06)
P = 0.23for interactionKidney, eGDR <median
0.84(0.68–1.02)
Kidney, eGDR ≥median
0.70(0.58–0.85)
P = 0.28for interactionFurther findings
Cardiovascular event incidence rate/100 patient-years by eGDR
- eGDR <median: finerenone; placebo
- 5.18; 6.34
- eGDR ≥median: finerenone; placebo
- 3.47; 3.76
- Median eGDR
- 4.1 mg/kg/min
- eGDR not associated with kidney outcomes
Sensitivity analyses
- Sensitivity analyses were consistent
Safety
- Finerenone demonstrated similar safety between subgroups
Original publication
Outcomes With Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Baseline Insulin Resistance. Diabetes Care. Published 27 December 2023. doi:10.
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