What question did this study set out to answer?

Investigate the impact of finerenone on all-cause mortality, cardiovascular mortality, and specific causes of death in patients with chronic kidney disease and type 2 diabetes.

January 12, 2023European Heart Journal - Cardiovascular PharmacotherapyOpen Access

Finerenone and effects on mortality in chronic kidney disease and type 2 diabetes: a FIDELITY analysis

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Why the study?

Finerenone reduces cardiovascular events in CKD and T2D, prompting an investigation into the specific causes of mortality in the FIDELITY population.

Does finerenone reduce all-cause and cardiovascular mortality in patients with chronic kidney disease and type 2 diabetes?

Key Points

Investigate the impact of finerenone on all-cause mortality, cardiovascular mortality, and specific causes of death in patients with chronic kidney disease and type 2 diabetes.
Prespecified pooled analysis of 13,026 patients from two randomized trials (FIDELIO-DKD [NCT02540993] and FIGARO-DKD [NCT02545049]), excluding individuals with heart failure with reduced ejection fraction.
At baseline, mean patient age was 64.8 years, mean eGFR was 57.6 mL/min/1.73 m2, and 99.8% were receiving background renin-angiotensin system inhibitors.
Evaluated intention-to-treat and on-treatment incidence and hazard ratios for all-cause death, cardiovascular death, and sudden cardiac death across up to 4 years of follow-up.
Finerenone lowered all-cause mortality versus placebo (8.5% vs. 9.4%) with a significant on-treatment reduction (HR, 0.82; 95% CI, 0.70–0.96; P = 0.014).
Cardiovascular mortality was reduced with finerenone compared to placebo (4.9% vs. 5.6%) in the on-treatment population (HR, 0.82; 95% CI, 0.67–0.99; P = 0.040).
Sudden cardiac death was significantly decreased with finerenone versus placebo in the intention-to-treat analysis (1.3% [0.44/100 patient-years] vs. 1.8% [0.58/100 patient-years]; HR, 0.75; 95% CI, 0.57–0.996; P = 0.046).

Structured PICO

Does finerenone reduce all-cause and cardiovascular mortality in patients with chronic kidney disease and type 2 diabetes?

Population

13,026 patients with chronic kidney disease (CKD) and type 2 diabetes (T2D), excluding patients with heart failure and reduced ejection fraction. Mean age 64.8 years, mean eGFR 57.6 mL/min/1.73 m2. 99.8% were on renin-angiotensin system inhibitors.

Intervention

Finerenone

Comparator

Placebo

Outcome

All-cause and cardiovascular mortalityhard clinical

In patients with chronic kidney disease and type 2 diabetes, finerenone significantly reduces the risk of all-cause mortality, cardiovascular mortality, and sudden cardiac death compared to placebo.

Discussion

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Implication

Finerenone reduces mortality in T2D-CKD; confirms cardiovascular protection extends to survival in broad CKD spectrum.

Cite This Study

Filippatos et al. (2023) studied this question.

synapsesocial.com/papers/6a8553b5581d4f62e2d59627 https://doi.org/10.1093/ehjcvp/pvad001

Topics

Heart failure HFrEF treatment HFpEF management

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Finerenone and effects on mortality in chronic kidney disease and type 2 diabetes: a FIDELITY analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

Finerenone and effects on mortality in chronic kidney disease and type 2 diabetes: a FIDELITY analysis

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

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