Effects of Finerenone in Persons with CKD and T2D are Independent of HbA1c at Baseline, HbA1c Variability, Diabetes Duration and Insulin Use at Baseline
Diabetes Obes Metab. 2023; online ahead of print DOI: 10.1111/dom.14999
Given the role of HbA1c, diabetes duration and insulin use in determining morbidity and mortality of CKD in T2D, it is important to investigate whether these factors modify the efficacy and safety of therapies that mitigate the cardiorenal impact of CKD in T2D. This post hoc analysis of the FIDELITY database evaluated the effect of finerenone by baseline HbA1c, HbA1c variability, diabetes duration and baseline insulin use on cardiorenal outcomes and diabetes progression.
Risk reductions in the CV and kidney composite outcomes with finerenone vs placebo were consistent across HbA1c quartiles, HbA1c variability, diabetes duration and insulin use. There was no effect on diabetes progression with finerenone or placebo. Adding to existing evidence, HbA1c variability in the first year of treatment was associated with higher risk of CV and kidney events. In the current study, finerenone was well tolerated across subgroups and discontinuations were low.