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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

Efficacy and safety of finerenone in patients with chronic kidney disease and type 2 diabetes by GLP-1RA treatment: A subgroup analysis from the FIDELIO-DKD trial

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DOI

  1. Effects of Dapagliflozin in Patients With Kidney Disease, With and Without Heart Failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Peter Rossing
  • Rajiv Agarwal
  • Stefan D Anker
  • Gerasimos Filippatos
  • Bertram Pitt
  • Luis M Ruilope
  • Aslam Amod
  • Michel Marre
  • Amer Joseph
  • Andrea Lage
  • Charlie Scott
  • George L Bakris
  • On Behalf Of The Fidelio-Dkd Investigators
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AIMS: Finerenone significantly reduced the risk of kidney and cardiovascular (CV) outcomes in patients with chronic kidney disease and type 2 diabetes in the FIDELIO-DKD trial (NCT02540993). This exploratory subgroup analysis investigates the effect of glucagon-like peptide-1 receptor agonist (GLP-1RA) use on the treatment effect of finerenone.

MATERIALS AND METHODS: Patients with type 2 diabetes, urine albumin-to-creatinine ratio (UACR) 30-5000 mg/g and estimated glomerular filtration rate 25-<75 ml/min per 1.73 m2 receiving optimized renin-angiotensin system blockade were randomized to finerenone or placebo.

RESULTS: Of the 5674 patients analysed, overall, 394 (6.9%) received GLP-1RAs at baseline. A reduction in UACR with finerenone was observed with or without baseline GLP-1RA use; ratio of least-squares means 0.63 (95% confidence interval 0.56, 0.70) with GLP-1RA use and 0.69 (95% confidence interval 0.67, 0.72) without GLP-1RA use (p value for interaction .20). Finerenone also significantly reduced the primary kidney (time to kidney failure, sustained decrease in estimated glomerular filtration rate ≥40% from baseline, or renal death) and key secondary CV outcomes (time to CV death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure) versus placebo, with no clear difference because of GLP-1RA use at baseline (p value for interaction .15 and .51 respectively) or any time during the trial. The safety profile of finerenone was similar between subgroups.

CONCLUSIONS: This exploratory subgroup analysis suggests that finerenone reduces UACR in patients with or without GLP-1RA use at baseline, and the effects on kidney and CV outcomes are consistent irrespective of GLP-1RA use.

Original languageEnglish
JournalDiabetes, Obesity and Metabolism
ISSN1462-8902
DOIs
Publication statusE-pub ahead of print - 28 Sep 2021

Bibliographical note

© 2021 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.

ID: 68399634