Key result
Finerenone cuts major CV events ~14% and improves kidney outcomes regardless of acute eGFR changes.
Why the study?
The study evaluated whether the efficacy and safety of finerenone versus placebo differed according to acute changes in estimated glomerular filtration rate after treatment initiation.
Does finerenone reduce composite cardiovascular and kidney outcomes in patients with CKD and type 2 diabetes irrespective of acute eGFR changes after initiation?
Meta-Analysis (n=12,990)
Double-blind
1:1
Yes
Does finerenone reduce composite cardiovascular and kidney outcomes in patients with CKD and type 2 diabetes irrespective of acute eGFR changes after initiation?
Effect estimate: HR 0.86 (95% CI 0.78-0.95)
p-value: p=0.0018
Finerenone improves cardiovascular and kidney outcomes in patients with CKD and type 2 diabetes, and these benefits are maintained regardless of any acute decline in eGFR following treatment initiation.
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Finerenone benefits hold irrespective of acute eGFR decline; extends FIDELITY evidence to eGFR trajectory subgroups.
Navaneethan et al. (2025) conducted a meta-analysis in Chronic kidney disease and type 2 diabetes (n=12,990). Finerenone vs. Placebo was evaluated on Composite cardiovascular outcome (time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) (HR 0.86, 95% CI 0.78-0.95, p=0.0018). Finerenone significantly reduced the risk of composite cardiovascular outcomes (HR 0.86) and kidney outcomes (HR 0.76) compared to placebo, and these benefits were not modified by an acute change in estimated glomerular filtration rate after drug initiation.
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