Outcomes with Finerenone in Participants with Stage 4 CKD and Type 2 Diabetes: A FIDELITY Subgroup Analysis
Clin J Am Soc Nephrol. 2023; online ahead of print DOI: 10.2215/CJN.0000000000000149
Patients with stage 4 CKD and T2D have limited treatment options to reduce their persistent CV and kidney risk. This post hoc analysis of the FIDELITY database evaluated the effect of finerenone vs placebo in 890 patients with stage 4 CKD and T2D.
Although a higher proportion of CV events occurred in participants with stage 4 CKD
vs participants with stage 1–3 CKD, the overall effect of finerenone on the CV composite outcome (CV death, non-fatal MI, non-fatal stroke or HF hospitalisation) was not significantly different across participants with varying CKD severity.
In participants with stage 4 CKD, finerenone vs placebo risk differences over time suggested a reduction in the risk of kidney outcomes (kidney failure, a sustained
≥57% eGFR decline or renal death) over the first 2 years. However, this effect was not consistent with the results observed beyond the 2-year timepoint.
The safety profile of finerenone in participants with stage 4 CKD was consistent with the overall FIDELITY population.
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