Key result
Finerenone improves HF outcomes vs placebo in CKD and T2D across baseline eGFR and UACR.
Why the study?
Risks of cardiovascular mortality and HF increase with decreasing eGFR and increasing UACR in T2D, prompting evaluation of finerenone on HF outcomes across these categories.
Does finerenone improve heart failure outcomes in patients with chronic kidney disease and type 2 diabetes across different eGFR and UACR categories?
RCT
Does finerenone improve heart failure outcomes in patients with chronic kidney disease and type 2 diabetes across different eGFR and UACR categories?
Finerenone improves heart failure outcomes in patients with chronic kidney disease and type 2 diabetes consistently across various levels of kidney function and albuminuria.
Answers are grounded in this paper and cite their sources.
Supports finerenone to reduce HF events in CKD/T2D across eGFR/UACR ranges; confirms consistent efficacy via meta-analysis.
BACKGROUND: In patients with type 2 diabetes (T2D), risks of cardiovascular mortality and heart failure (HF) increase with decreasing kidney function (estimated glomerular filtration rate [eGFR]) and increasing albuminuria (urine albumin-to-creatinine ratio [UACR]). Finerenone, a selective, nonsteroidal mineralocorticoid receptor antagonist, improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and T2D in FIDELITY (Finerenone in Chronic Kidney Disease and Type 2 Diabetes: Combined FIDELIO-DKD and FIGARO-DKD Trial Programme Analysis). OBJECTIVES: This study sought to evaluate the effects of finerenone on HF outcomes by eGFR and/or UACR categories. METHODS: ) and/or UACR (<300 and ≥300 mg/g). RESULTS: and a UACR <300 mg/g. Finerenone improved HF outcomes irrespective of baseline eGFR and/or UACR categories (all P interaction values >0.10). CONCLUSIONS: Compared with placebo, finerenone improved HF-related outcomes in patients with CKD and T2D, with consistent benefits across eGFR and/or UACR categories. (Efficacy and Safety of Finerenone in Subjects With Type 2 Diabetes Mellitus and Diabetic Kidney Disease [FIDELIO-DKD], NCT02540993; Efficacy and Safety of Finerenone in Subjects With Type 2 Diabetes Mellitus and the Clinical Diagnosis of Chronic Kidney Disease [FIGARO-DKD], NCT02545049).
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Filippatos et al. (2022) conducted an RCT in Chronic Kidney Disease and Type 2 Diabetes. Finerenone vs. Placebo was evaluated on Heart failure outcomes. Finerenone improved heart failure outcomes compared with placebo in patients with CKD and T2D, with consistent benefits across baseline eGFR and UACR categories.
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