Key result
Finerenone resulted in a non-significant numerical decrease in the primary cardiovascular composite outcome (HR 0.91) and significantly reduced the key secondary kidney outcome (HR 0.48) compared to placebo in Chinese patients with type 2 diabetes and chronic kidney disease.
Why the study?
Type 2 diabetes is a growing burden in China with high risk of chronic kidney disease, prompting exploration of cardiovascular and kidney benefits of finerenone in this population.
Does finerenone reduce cardiovascular and kidney events in Chinese patients with chronic kidney disease and type 2 diabetes?
RCT (n=325)
Double-blind
1:1
Yes
Does finerenone reduce cardiovascular and kidney events in Chinese patients with chronic kidney disease and type 2 diabetes?
In Chinese patients with type 2 diabetes and chronic kidney disease, finerenone significantly reduced the risk of kidney outcomes and showed a trend toward cardiovascular benefit, consistent with the overall FIGARO-DKD trial.
Supports kidney protection with finerenone in Chinese T2D-CKD patients; extends global RCT evidence while leaving cardiovascular benefit inconclusive.
Background Type 2 diabetes (T2D) is a considerable and growing burden in the Chinese population, and affected adults are at high risk of developing chronic kidney disease (CKD). This subgroup analysis of the FIGARO-DKD trial explored the cardiovascular and kidney benefits of finerenone in Chinese patients with CKD and T2D on optimized renin–angiotensin system blockade. Methods Patients with urine albumin-to-creatinine ratio (UACR) ≥30–<300 mg/g and estimated glomerular filtration rate (eGFR) ≥25–≤90 mL/min/1.73 m 2 , or UACR ≥300–≤5000 mg/g and eGFR ≥60 mL/min/1.73 m 2 , were randomized to finerenone or placebo. The primary cardiovascular composite outcome was time to cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure. The secondary kidney composite outcome was time to kidney failure, sustained eGFR decline ≥40% from baseline, or kidney-related death. Results A total of 325 Chinese patients were included. Finerenone resulted in a numerical decrease in the risk of the cardiovascular composite outcome (hazard ratio 0.91; 95% confidence interval 0.50–1.67) and a significantly reduced risk of the key secondary kidney outcome (hazard ratio 0.48; 95% confidence interval 0.29–0.79; p = 0.0029). The incidence of investigator-reported hyperkalemia was high across both treatment arms. Nevertheless, the incidence of hyperkalemia leading to hospitalization and treatment discontinuation was low across treatment arms. Conclusions Finerenone significantly reduced the composite kidney outcome, showed a trend to reduce cardiovascular outcomes, and demonstrated an acceptable safety profile in Chinese patients.
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Li et al. (2025) conducted an RCT in Type 2 diabetes and chronic kidney disease (n=325). Finerenone vs. Placebo was evaluated on Time to cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure (HR 0.91, 95% CI 0.50-1.67, p=0.7660). Finerenone resulted in a non-significant numerical decrease in the primary cardiovascular composite outcome (HR 0.91) and significantly reduced the key secondary kidney outcome (HR 0.48) compared to placebo in Chinese patients with type 2 diabetes and chronic kidney disease.
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