follow-up was 119.5 (1-337) days.At baseline, mean (SD) eGFR was 55 (21) mL/min/1.73m2 (n=1255) and median (IQR) UACR was 515 mg/g (n=943), versus mean (SD) eGFR 55 (20) mL/min/1.73m2 and median (IQR) UACR 629 (262-1354) in the FIDELITY Asian population (n=2858).1Mean (SD) HbA1c was 7.5 (1.5) % (n=1014).Concomitant RAASi, SGLT2i, and GLP-1 RA were used by 1064 (83%), 784 (61%), and 185 (14%) pts, respectively.Finerenone was initiated at 10 mg in 984 (77%) and 20 mg in 302 (23%) pts, respectively; 18% of pts initiated on 10 mg were up-titrated at least once and 8% of pts initiated on 20 mg were down-titrated at least once.UACR data for pts with values at baseline and follow-up are shown in the table.UACR declined between baseline and 4 months and 12 months, with reductions from baseline in median UACR of 41% and 42%, respectively, exceeding the ADA recommendation of >30% reduction.2 TEAEs and treatment-emergent serious AEs were observed in 379 (29%) and 110 (9%) pts, respectively.Treatment-emergent hyperkalemia events were reported in 104 (8%) pts, leading to permanent discontinuation in 5 (0.4%); serious treatment-emergent hyperkalemia events were reported in 2 (0.2%) pts, leading to hospitalization in 1 (<0.1%);no hyperkalemia events were life-threatening or led to dialysis or death.Conclusion: Despite use of other guideline-directed therapies in many pts, finerenone reduced UACR between baseline and 4 months; this effect was maintained at 12 months.Kidney impairment at baseline in the APAC cohort of FINE-REAL was less severe compared with the FIDELITY Asian population.1A greater proportion of FINE-REAL pts received concomitant SGLT2i or GLP-1 RA than in the FIDELITY Asian population or recent registries; RAASi use was greater in the FIDELITY Asian population.1,3-5Safety was favorable and consistent with the known safety profile of finerenone.
Sharma et al. (2026) studied this question.