medwireNews: Pooled analysis of FIDELIO-DKD and FIGARO-DKD suggests that people with type 2 diabetes and chronic kidney disease benefit from finerenone irrespective of whether they are also using a sodium-glucose cotransporter (SGLT)2 inhibitor.
In all, 6.7% of the 13,026 trial participants were taking an SGLT2 inhibitor at trial entry, evenly balanced between the finerenone and placebo groups. These people had a significant 33% reduction in the risk for the composite cardiovascular endpoint with finerenone versus placebo treatment and a 58% reduction in risk for the composite renal endpoint.
The corresponding risk reductions in people not taking an SGLT2 inhibitor were 13% and 20%. Although those taking SGLT2 inhibitors had larger risk reductions than people not taking them, the differences were not statistically significant.
The findings were similar for all-cause mortality and, in a post-hoc analysis, for heart failure hospitalization. Event rates were generally lower among people taking SGLT2 inhibitors than those not taking them, which Peter Rossing (Steno Diabetes Center Copenhagen, Denmark) and co-researchers attribute to baseline differences between the two groups.
Writing in Diabetes Care, the team reports “no concerning safety signals” with the combination of finerenone and SGLT2 inhibition, and suggests that the efficacy of the combination should be formally tested for superiority to the single medications in people already taking renin–angiotensin system inhibitors.
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