Efficacy of Finerenone in Patients with Type 2 Diabetes, Chronic Kidney Disease and Altered Markers of Liver Steatosis and Fibrosis: A FIDELITY Subgroup Analysis
Diabetes Obes Metab. 2023; online ahead of print DOI: 10.1111/dom.15305
This post hoc subgroup analysis from FIDELITY investigated the effect of finerenone on liver function, cardiovascular and kidney composite outcomes in patients with CKD and T2D, stratified by their risk of liver steatosis, inflammation and fibrosis.
Patients (n=13,026) were analysed by liver fibrosis and enzymes: high risk of steatosis (hepatic steatosis index >36); elevated transaminases (ALT >33 [males] and >25 IU/L [females]); and fibrosis-4 (FIB-4) index scores >3.25, >2.67 and >1.30. Liver enzymes were assessed by changes in ALT, AST and GGT. Composite kidney outcome was defined as onset of kidney failure, sustained eGFR decline ≥57% from baseline over ≥4 weeks or kidney death. Composite CV outcome was defined as CV death, non-fatal MI, non-fatal stroke or hospitalisation for HF.
Finerenone had neutral effects on liver parameters in patients with CKD and T2D. Finerenone showed robust and consistent kidney benefits in patients with altered liver tests, and CV benefits even in patients with higher FIB-4 scores who were at high risk of developing CV complications.
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