Key result
Combination therapy with finerenone and empagliflozin led to a significantly greater reduction in the urinary albumin-to-creatinine ratio than either agent alone.
Why the study?
Does combination therapy with finerenone and empagliflozin reduce the urinary albumin-to-creatinine ratio more than either agent alone in patients with chronic kidney disease and type 2 diabetes?
Does combination therapy with finerenone and empagliflozin reduce the urinary albumin-to-creatinine ratio more than either agent alone in patients with chronic kidney disease and type 2 diabetes?
The authors caution against adopting combination finerenone and empagliflozin as standard care based solely on the surrogate marker of urinary albumin-to-creatinine ratio reduction.
To the Editor: The CONFIDENCE trial, conducted by Agarwal et al. (Aug. 7 issue), 1 showed that combination therapy with finerenone and empagliflozin led to a significantly greater reduction in the urinary albumin-to-creatinine ratio than either agent alone. As the authors note, the urinary albumin-to-creatinine ratio here is a surrogate marker for progression of chronic kidney disease (CKD) and, potentially, for adverse cardiovascular and renal events. However, sole reliance on a reduction in the urinary albumin-to-creatinine ratio as evidence to adopt this regimen, and to potentially consider it as standard care, in patients with CKD and type 2 diabetes is of . . .
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A 2025 study conducted a letter in Chronic kidney disease and type 2 diabetes. Finerenone with empagliflozin vs. Either agent alone was evaluated on Reduction in the urinary albumin-to-creatinine ratio. Combination therapy with finerenone and empagliflozin led to a significantly greater reduction in the urinary albumin-to-creatinine ratio than either agent alone.
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