Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes According to Baseline HbA1c and Insulin Use: An Analysis From the FIDELIO-DKD Study
Authors: Peter Rossing, Ellen Burgess, Rajiv Agarwal, Stefan D. Anker, Gerasimos Filippatos, Bertram Pitt, Luis M. Ruilope, Pieter Gillard, Richard J. MacIsaac, Julio Wainstein, Amer Joseph, Meike Brinker, Lothar Roessig, Charlie Scott, George L. Bakris, Augusto Vallejos, Richard MacIsaac, Guntram Schernthaner, Pieter Gillard, Maria Eugenia F. Canziani, Theodora Temelkova-Kurktschiev, Ellen Burgess, Sheldon Tobe, Fernando González, Zhi-Hong Liu, Andrés Ángelo, Cadena Bonfanti, Carlos Francisco Jaramillo, Martin Prazny, Peter Rossing, Jorma Strand, Michel Marre, Roland Schmieder, Christoph Wanner, Pantelis A. Sarafidis, Juliana Chan, László Rosivall, Joseph Eustace, Ehud Grossman, Yoram Yagil, Giuseppe Remuzzi, Daisuke Koya, Takashi Wada, Magdalena Madero Rovalo, Ron Gansevoort, Adriaan Kooy, Trine Finnes, Froilan De Leon, Janusz Gumprecht, Fernando Teixeira e Costa, Alexander Dreval, Anantharaman Vathsala, Aslam Amod, Sin Gon Kim, Byung Wan Lee, Julio Pascual Santos, Bengt-Olov Tengmark, Michel Burnier, Chien-Te Lee, Sukit Yamwong, Ramazan Sari, Kieran McCafferty, Borys Mankovsky, Sharon Adler, Linda Fried, Robert Toto, Mark Williams, Tran Quang Khanh, Diego Aizenberg, Inés Bartolacci, Diego Besada, Julio Bittar, Mariano Chahin, Alicia Elbert, Elizabeth Gelersztein, Alberto Liberman, Laura Maffei, Federico Pérez Manghi, Hugo Sanabria, Gloria Viñes, Alfredo Wassermann, Walter Abhayaratna, Shamasunder Acharya, Elif Ekinci, Darren Lee, Peak Mann Mah, Craig Nelson, David Packham, Alexia Pape, Simon Roger, Hugo Stephenson, Michael Suranyi, Gary Wittert, Elizabeth Vale, Martin Clodi, Christoph Ebenbichler, Evelyn Fliesser-Görzer, Ursula Hanusch, Michael Krebs, Karl Lhotta, Bernhard Ludvik, Gert Mayer, Peter Neudorfer, Bernhard Paulweber, Rudolf Prager, Wolfgang Preiß, Friedrich Prischl, Gerit-Holger Schernthaner, Harald Sourij, Martin Wiesholzer, Peter Doubel, Wendy Engelen, Jean-Michel Hougardy, Jean-Marie Krzesinski, Bart Maes, Marijn Speeckaert, Koen Stas, Luc van Gaal, Hilde Vanbelleghem, Daniela Antunes, Roberto Botelho, Claudia Brito, Luis Canani, Maria Eugenia Canziani, Maria Cerqueira, Rogerio de Paula, Freddy Eliaschewitz, Carlos Eduardo Figueiredo, Adriana Forti, Miguel Hissa, Maurilo Leite Jr, Emerson Lima, Irene Noronha, Bruno Paolino, Nathalia Paschoalin, Raphael Paschoalin, Roberto Pecoits Filho, Marcio Pereira, Evandro Portes, Dalton Precoma, Rosangela Rea, Miguel Riella, Joao Eduardo Salles, Eduardo Vasconcellos, Sergio Vencio, Emiliya Apostolova, Radostina Boshnyashka, Ghassan Farah, Dimitar Georgiev, Valentina Gushterova, Neli Klyuchkova, Mariya Lucheva, Petya Manova, Dotska Minkova, Boyan Nonchev, Mariyana Pichmanova, Zhulieta Prakova, Rangel Rangelov, Rosen Rashkov, Pavel Stanchev, Bilyana Stoyanovska-Elencheva, Zhivko Tagarev, Theodora Temelkova-Kurktschieva, Svetla Vasileva, Mariana Yoncheva-Mihaylova, Paul Barre, Brian Carlson, James Conway, Serge Cournoyer, Richard Dumas, Sameh Fikry, Richard Goluch, Pavel Hamet, Randolph Hart, Sam Henein, Joanne Liutkus, Francois Madore, Valdemar Martinho, Giuseppe Mazza, Philip McFarlane, Dennis O'Keefe, Sean Peterson, Daniel Schwartz, Daniel Shu, Andrew Steele, Guy Tellier, Karthik Tennankore, George Tsoukas, Richard Tytus, Louise Vitou, Michael Walsh, Stanley Weisnagel, Igor Wilderman, Jean-Francois Yale, Jorge Cobos, Juan Godoy, Sergio Lobos, Juan Carlos Palma, Juan Carlos Prieto, Eliana Reyes, Carmen Romero, Victor Saavedra, Mario Vega, Ruifang Bu, Hanqing Cai, Nan Chen, Qinkai Chen, Dejun Chen, Jinluo Cheng, Youping Dong, Junwu Dong, Tianjun Guan, Chuanming Hao, Wen Huang, Fangfang Jiang, Minxiang Lei, Ling Li, Zhonghe Li, Xuemei Li, Jingmei Li, Yan Li, Xinling Liang, Bo Liang, Fang Liu, Yinghong Liu, Yuantao Liu, Zhihong Liu, Gang Long, Guoyuan Lu, Weiping Lu, Yibing Lu, Ping Luo, Jianhua Ma, Zhaohui Mo, Jianying Niu, Ai Peng, Jiansong Shen, Feixia Shen, Bingyin Shi, Qing Su, Zhuxing Sun, Shuifu Tang, Nanwei Tong, Hao Wang, Xinjun Wang, Lihua Wang, Guixia Wang, Jianqin Wang, Yangang Wang, Li Wang, Jiali Wei, Tianfeng Wu, Chaoqing Wu, Changying Xing, Fei Xiong, Xudong Xu, Ning Xu, Tiekun Yan, Jinkui Yang, Aiping Yin, Longyi Zeng, Hao Zhang, Yanlin Zhang, Ying Zhang, Wenjing Zhao, Zhiquan Zhao, Hongguang Zheng, Ling Zhong, Dalong Zhu, Yongze Zhuang, Clara Arango, Sandra Barrera, Nelly Beltrán López, Diego Benitez, Guillermo Blanco, Andrés Cadena, Julian Coronel, Carlos Cure, Carlos Durán, Alexander González, Gustavo Guzmán, Eric Hernández, Jaime Ibarra, Carlos Jaramillo, Nicolás Jaramillo, William Kattah, Dora Molina, Gregorio Sánchez, Mónica Terront, Freddy Trujillo, Miguel Urina, Ruben Vargas, Iván Villegas, Hernán Yupanqui, Dino Alferi, Michal Brada, Jiri Brezina, Petr Bucek, Tomas Edelsberger, Drahomira Gulakova, Jitka Hasalova Zapletalova, Olga Hola, Lucie Hornova, Jana Houdova, Helena Hrmova, David Karasek, Sarka Kopecka, Richard Kovar, Eva Krcova, Jiri Kuchar, Vlasta Kutejova, Hana Lubanda, Ivo Matyasek, Magdalena Mokrejsova, Libor Okenka, Jiri Pumprla, Pavel Tomanek, Jesper Bech, Jens Faber, Gunnar Gislason, Jørgen Hangaard, Grzegorz Jaroslaw Pacyk, Claus Juhl, Thure Krarup, Morten Lindhardt, Sten Madsbad, Joan Nielsen, Ulrik Pedersen-Bjergaard, Per Poulsen, Ole Rasmussen, Karoline Schousboe, Mikko Honkasalo, Kari Humaloja, Kristiina Kananen, Ilkka Kantola, Arvo Koistinen, Pirkko Korsoff, Jorma Lahtela, Sakari Nieminen, Tuomo Nieminen, Karita Sadeharju, Sakari Sulosaari, Bertrand Cariou, François Chantrel, Sylvaine Clavel, Christian Combe, Jean-Pierre Fauvel, Karim Gallouj, Didier Gouet, Bruno Guerci, Dominique Guerrot, Maryvonne Hourmant, Alexandre Klein, Christophe Mariat, Rafik Mesbah, Yannick Le Meur, Arnaud Monier, Olivier Moranne, Pierre Serusclat, Benoit Vendrely, Bruno Verges, Philippe Zaoui, Christoph Axthelm, Andreas Bergmann, Andreas L. Birkenfeld, Hermann Braun, Klaus Busch, Christel Contzen, Stefan Degenhardt, Karl Derwahl, Thomas Giebel, Andreas Hagenow, Hermann Haller, Christoph Hasslacher, Thomas Horacek, Wolfgang Jungmair, Christof Kloos, Thorsten Koch, Thilo Krüger, Anja Mühlfeld, Joachim Müller, Andreas Pfützner, Frank Pistrosch, Ludger Rose, Lars Rump, Volker Schettler, Ingolf Schiefke, Heike Schlichthaar, Bernd Schröppel, Thomas Schürholz, Helena Sigal, Lutz Stemler, Georg Strack, Heidrun Täschner, Nicole Toursarkissian, Diethelm Tschöpe, Achim Ulmer, Markus van der Giet, Bernhard R. Winkelmann, Ioannis Boletis, Erifili Hatziagelaki, Ioannis Ioannidis, Theodora Kounadi, Ioanna Makriniotou, Dorothea Papadopoulou, Aikaterini Papagianni, Ploumis Passadakis, Ioannis Stefanidis, Tai Pang Ip, Paul Lee, On Yan Andrea Luk, Angela Wang, Vincent Yeung, Dora Bajcsi, Peter Danos, Eleonora Harcsa, Szilvia Kazup, Katalin Keltai, Robert Kirschner, Julianna Kiss, Laszlo Kovacs, Beata Lamboy, Botond Literati-Nagy, Margit Mileder, Laszlo Nagy, Ebrahim Noori, Gabor Nyirati, Gizella Petro, Karoly Schneider, Albert Szocs, Szilard Vasas, Krisztina Wudi, Zsolt Zilahi, Marianna Zsom, Joe Eustace, John Holian, Donal Reddan, Yvonne O'Meara, Rosane Abramof Ness, Faiad Adawi, Zaher Armaly, Shaul Atar, Sydney Ben Chetrit, Noa Berar Yanay, Gil Chernin, Mahmud Darawsha, Shai Efrati, Mazen Elias, Evgeny Farber, Mariela Glandt, Majdi Halabi, Khaled Khazim, Idit Liberty, Ofri Mosenzon, Assy Nimer, Doron Schwartz, Julio Wainstein, Robert Zukermann, Aneliya Ilieva Parvanova, Angelo Avogaro, Giovanni Giorgio Battaglia, Maurizio Tiziano Bevilacqua, Enzo Bonora, Carlo Antonio Bossi, Paolo Calabrò, Franco Luigi Cavalot, Roberto Cimino, Mario Gennaro Cozzolino, Salvatore David, Michele Emdin, Enrico Fiaccadori, Paolo Fiorina, Carlo Bruno Giorda, Maria Cristina Gregorini, Gaetano La Manna, Davide Carlo Maggi, Roberta Manti, Giancarla Meregalli, Antonello Pani, Norberto Perico, PierMarco Piatti, Antonio Pisani, Antonio Ettore Pontiroli, Paola Ponzani, Gennaro Santorelli, Domenico Santoro, Renzo Scanziani, Ugo Teatini, Giancarlo Tonolo, Roberto Trevisan, Anna Maria Veronelli, Giorgio Luciano Viviani, Hideo Araki, Osamu Ebisui, Naruhiro Fujita, Ryuichi Furuya, Yoshiyuki Hamamoto, Masahiro Hatazaki, Terumasa Hayashi, Takayuki Higashi, Yoshihide Hirohata, Shuji Horinouchi, Masayuki Inagaki, Masao Ishii, Tamayo Ishiko, Hideaki Jinnouchi, Hidetoshi Kanai, Daisuke Kanda, Hideo Kanehara, Masayuki Kashima, Kiyoe Kato, Takeshi Katsuki, Katsunori Kawamitsu, Satsuki Kawasaki, Fumi Kikuchi, Hidetoshi Kikuchi, Kunihisa Kobayashi, Junko Koide, Miyuki Kubota, Yoshiro Kusano, Hajime Maeda, Sunao Matsubayashi, Kazunari Matsumoto, Yasuto Matsuo, Naoki Matsuoka, Hiroaki Miyaoka, Satoshi Murao, Mikihiro Nakayama, Jun Nakazawa, Takashi Nomiyama, Masayuki Noritake, Takayuki Ogiwara, Hiroshi Ohashi, Hideki Okamoto, Takeshi Osonoi, Nobuhiro Sasaki, Taiji Sekigami, Taro Shibasaki, Hirotaka Shibata, Junji Shinoda, Hiroshi Sobajima, Kazuya Sugitatsu, Toshiyuki Sugiura, Toru Sugiyama, Daisuke Suzuki, Hiroyuki Suzuki, Masaaki Suzuki, Asami Takeda, Asami Tanaka, Seiichi Tanaka, Izumi Tsunematsu, Makoto Ujihara, Daishiro Yamada, Masayo Yamada, Kazuo Yamagata, Ken Yamakawa, Fumiko Yamakawa, Yoshimitsu Yamasaki, Yuko Yambe, Taihei Yanagida, Hidekatsu Yanai, Tetsuyuki Yasuda, Dovile Kriauciuniene, Jurate Lasiene, Antanas Navickas, Lina Radzeviciene, Egle Urbanaviciene, Gediminas Urbonas, Audrone Velaviciene, Rohana Abd Ghani, Nor Azizah Aziz, Li Yuan Lee, Chek Loong Loh, Norhaliza Mohd Ali, Nurain Mohd Noor, Nik Nur Fatnoon, Nik Ahmad, Jeyakantha Ratnasingam, Wan Hasnul Halimi Bin, Wan Hasan, Wan Mohd Izani, Wan Mohamed, Sandro Avila Pardo, Miriam Bastidas Adrian, Alfredo Chew Wong, Jorge Escobedo de la Peña, Guillermo Fanghänel Salmón, Guillermo González Gálvez, Ramiro Gutiérrez Ochoa, Saúl Irizar Santana, Gustavo Méndez Machado, Luis Nevarez Ruiz, Denisse Ramos Ibarra, Gabriel Ramos López, Leobardo Sauque Reyna, Gustavo Solache Ortiz, Rafael Valdez Ortiz, Juan Villagordoa Mesa, R.C. Bakker, J.N.M. Barendregt, A.H. Boonstra, Willem Bos, C.B. Brouwer, M. van Buren, Marielle Krekels, Ruud J.M. van Leendert, Louis A.G. Lieverse, P.T. Luik, E. Lars Penne, Peter Smak Gregoor, Liffert Vogt, John Baker, Veronica Crawford, Rick Cutfield, Peter Dunn, Jeremy Krebs, Kingsley Nirmalaraj, Russell Scott, Nine Smuts, Erik Eriksen, Hans Høivik, Thomas Karlsson, Peter Scott Munk, Maria Radtke, Knut Risberg, Jan Rocke, Leidulv Solnør, Aud-Eldrid Stenehjem, Anne-Beathe Tafjord, Glenda Pamugas, Araceli Panelo, Ronald Perez, Maribel Tanque, Louie Tirador, Michael Villa, Patrycja Butrymowicz, Kazimierz Ciechanowski, Grazyna Cieslik, Edward Franek, Michal Hoffmann, Jolanta Krzykowska, Ilona Kurnatowska, Katarzyna Landa, Adam Madrzejewski, Katarzyna Madziarska, Stanislaw Mazur, Piotr Napora, Michal Nowicki, Anna Ocicka-Kozakiewicz, Barbara Rewerska, Teresa Rusicka, Jan Ruxer, Ewa Skokowska, Andrzej Stankiewicz, Tomasz Stompor, Agnieszka Tiuryn-Petrulewicz, Katarzyna Wasilewska, Bogna Wierusz-Wysocka, Renata Wnetrzak-Michalska, Edgar Almeida, Rosa Ballesteros, Carlos Barreto, Idalina Beirao, Rita Birne, Cesar Esteves, Jose Guia, Susana Heitor, Olinda Marques, Pedro Melo, Fernando Nolasco, Amalia Pereira, Cristina Roque, Francisco Rosario, Gil Silva, Ana Silva, Ana Vila Lobos, Gregorio Cortes-Maisonet, Amaury Roman-Miranda, Adrian Albota, Cornelia Bala, Hortensia Barbonta, Elena Caceaune, Doina Catrinoui, Ciprian Constantin, Adriana Dumitrescu, Nicoleta Mindrescu, Cristina Mistode, Gabriela Negrisanu, Adriana Onaca, Silvia Paveliu, Ella Pintilei, Lavinia Pop, Amorin Popa, Alexandrina Popescu, Gabriela Radulian, Iosif Szilagyi, Liana Turcu, Georgeta Vacaru, Adrian Vlad, Mikhail Antsiferov, Mikhail Arkhipov, Andrey Babkin, Olga Barbarash, Vitaliy Baranov, Elena Chernyavskaya, Arkadiy Demko, Anton Edin, Polina Ermakova, Valentin Fadeev, Albert Galyavich, Leyla Gaysina, Ivan Gordeev, Irina Ipatko, Marina Kalashnikova, Yuriy Khalimov, Vadim Klimontov, Zhanna Kobalava, Elena Kosmacheva, Natalya Koziolova, Lyudmila Kvitkova Sergey Levashov, Roman Libis, Vyacheslav Marasaev, Natalia Malykh, Vladimir Martynenko, Sofya Malyutina, Imad Merai, Ashot Mkrtumyan, Galina Nechaeva, Nina Petunina, Shamil Palyutin, Leonid Pimenov, Elena Rechkova, Tatyana Rodionova, Oksana Rymar, Ruslan Sardinov, Olga Semenova, Alexander Sherenkov, Oleg Solovev, Elena Smolyarchuk, Leonid Strongin, Olga Ukhanova, Nadezhda Verlan, Natalya Vorokhobina, Davyd Yakhontov, Sergey Yakushin, Elena Zakharova, Alsu Zalevskaya, Olga Zanozina, Elena Zhdanova, Larisa Zhukova, Tatyana Zykova, Chee Fang Sum, Sufi Muhummad Suhail, Ru San Tan, Edmund Wong, Jana Babikova, Ingrid Buganova, Andrej Dzupina, Zuzana Ochodnicka, Dalibor Sosovec, Denisa Spodniakova, Fayzal Ahmed, Sindeep Bhana, Larry Distiller, Dirkie Jansen van Rensburg, Mukesh Joshi, Shaifali Joshi, Deepak Lakha, Essack Mitha, Gracjan Podgorski, Naresh Ranjith, Brian Rayner, Paul Rheeder, Mohamed Sarvan, Mary Seeber, Heidi Siebert, Mohammed Tayob, Julien Trokis, Dorothea Urbach, Louis van Zyl, Bum-Soon Choi, Moon Gi Choi, ChoonHee Chung, YouCheol Hwang, ChongHwa Kim, InJoo Kim, JaeHyeon Kim, SinGon Kim, SungGyun Kim, Tae Hee Kim, WooJe Lee, ByungWan Lee, Kang Wook Lee, Kook-Hwan Oh, Ji Eun Oh, Yun Kyu Oh, Dong-Jin Oh, Junbeom Park, Seok Joon Shin, Su-Ah Sung, Jae Myung Yu, Irene Agraz, Francisco Javier Ampudia, Hanane Bouarich, Francesca Calero, Cristina Castro, Secundino Cigarrán Guldris, Josep Cruzado Garrit, Fernando de Álvaro, Josep Galcerán, Olga González Albarrán, Julio Hernández Jaras, Meritxell Ibernón, Francisco Martínez Deben, Ma Dolores Martínez Esteban, José María Pascual Izuel, Judith Martins, Juan Mediavilla, Alfredo Michán, Esteban Poch, Manuel Polaina Rusillo, Carlos Sánchez Juan, Rafael Santamaría Olmo, José Julián, Segura de la Morena, Alfonso Soto, Maribel Troya, Annette Bruchfeld, Dan Curiac, Ken Eliasson, Malin Frank, Gregor Guron, Olof Hellberg, Margareta Hellgren, Hans Larnefeldt, Carl-Johan Lindholm, Magnus Löndahl, Erik Rein-Hedin, Inga Soveri, Jonas Spaak, Daniel Ackermann, Stefan Bilz, Christian Forster, Stefan Kalbermatter, Andreas Kistler, Antoinette Pechére-Bertschi, Bernd Schultes, Chiz-Tzung Chang, Cheng-Chieh Hung, Ju-Ying Jiang, Shuei-Liong Lin, Der-Cherng Tarng, Shih-Te Tu, Mai-Szu Wu, Ming-Ju Wu, Chaicharn Deerochanawong, Chagriya Kitiyakara, Vuddhidej Ophascharoensuk, Chatlert Pongchaiyakul, Bancha Satirapoj, Necmi Eren, Ibrahim Gul, Okan Gulel, Ismail Kocyigit, Abdulbaki Kumbasar, Idris Sahin, Burak Sayin, Talat Tavli, Sedat Ustundag, Yavuz Yenicerioglu, Iryna Bondarets, Volodymyr Botsyurko, Viktoriia Chernikova, Oleksandra Donets, Ivan Fushtey, Mariia Grachova, Anna Isayeva, Dmytro Kogut, Julia Komisarenko, Nonna Kravchun, Kateryna Malyar, Liliya Martynyuk, Vitaliy Maslyanko, Halyna Myshanych, Larysa Pererva, Nataliia Pertseva, Oleksandr Serhiyenko, Ivan Smirnov, Liubov Sokolova, Vasyl Stryzhak, Maryna Vlasenko, Ahmad AbouSaleh, Jonathan Barratt, Cuong Dang, Hassan Kahal, Adam Kirk, Anne Kilvert, Sui Phi Kon, Dipesh Patel, Sam Rice, Arutchelvam Vijayaraman, Yuk-ki Wong, Martin Gibson, Mona Wahba, Reza Zaidi, Idalia Acosta, Atoya Adams, Dilawar Ajani, Slamat Ali, Radica Alicic, Amer Al-Karadsheh, Sreedhara Alla, D. Allison, Nabil Andrawis, Ahmed Arif, Ahmed Awad, Masoud Azizad, Michael Bahrami, Shweta Bansal, Steven Barag, Ahmad Barakzoy, Mark Barney, Joshua Barzilay, Khalid Bashir, Jose Bautista, Srinivasan Beddhu, Diogo Belo, Sabrina Benjamin, Ramin Berenji, Anuj Bhargava, Jose Birriel, Stephen Brietzke, Frank Brosius, Osvaldo Brusco, Anna Burgner, Robert Busch, Rafael Canadas, Maria Caramori, Jose Cardona, Christopher Case, Humberto Cruz, Ramprasad Dandillaya, Dalia Dawoud, Zia Din, Bradley Dixon, Ankur Doshi, James Drakakis, Mahfouz El Shahawy, Ashraf El-Meanawy, Mohammed El-Shahawy, John Evans, George Fadda, Umar Farooq, Roland Fernando, Raymond Fink, Brian First, David Fitz-Patrick, John Flack, Patrick Fluck, Leon Fogelfeld, Vivian Fonseca, Juan Frias, Claude Galphin, Luis Garcia-Mayol, Gary Goldstein, Edgar Gonzalez, Francisco Gonzalez-Abreu, Ashwini Gore, David Grant, Violet Habwe, Maxine Hamilton, Jamal Hammoud, Stuart Handelsman, Israel Hartman, Glenn Heigerick, Andrew Henry, German Hernandez, Carlos Hernandez-Cassis, Carlos Herrera, Joachim Hertel, Wenyu Huang, Rogelio Iglesias, Ali Iranmanesh, Timothy Jackson, Mahendra Jain, Kenneth Jamerson, Karen Johnson, Eric Judd, Joshua Kaplan, Zeid Kayali, Bobby Khan, Muhammad Khan, Sourabh Kharait, M. Sue Kirkman, Nelson Kopyt, Wayne Kotzker, Csaba Kovesdy, Camil Kreit, Arvind Krishna, Saeed Kronfli, Keung Lee, Derek LeJeune, Brenda Lemus, Carlos Leon-Forero, Douglas Linfert, Henry Lora, Alexander Lurie, Geetha Maddukuri, Alexander Magno, Louis Maletz, Sreedhar Mandayam, Mariana Markell, Ronald Mayfield, Caroline Mbogua, Dierdre McMullen, Carl Meisner, Stephen Minton, Bharat Mocherla, Rajesh Mohandas, Manuel Montero, Moustafa Moustafa, Salil Nadkarni, Samer Nakhle, Jesus Navarro, Nilda Neyra, Romanita Nica, Philip Nicol, Paul Norwood, Visal Numrungroad, Richard O'Donovan, A. Odugbesan, Jorge Paoli-Bruno, Samir Parikh, Rakesh Patel, Aldo Peixoto, Pablo Pergola, Alan Perlman, Karlton Pettis, Roberto Pisoni, Mirela Ponduchi, Jorge Posada, Sharma Prabhakar, Jai Radhakrishnan, Mahboob Rahman, Rupesh Raina, Anjay Rastogi, Efrain Reisin, Marc Rendell, David Robertson, Michael Rocco, Hugo Romeu, Sylvia Rosas, Jack Rosenfeld, Dennis Ross, Jeffrey Rothman, Lance Rudolph, Yusuf Ruhullah, Gary Ruoff, Jeffrey Ryu, Mandeep Sahani, Ramin Sam, Garfield Samuels, William Sanchez, Vladimir Santos, Scott Satko, Sanjeev Saxena, David Scott, Gilberto Seco, Melvin Seek, Harvey Serota, Tariq Shafi, Nauman Shahid, Michael Shanik, Santosh Sharma, Arjun Sinha, James Smelser, Mark Smith, Kyaw Soe, Richard Solomon, Eugene Soroka, Joseph Soufer, Bruce Spinowitz, Leslie Spry, Rosa Suarez, Bala Subramanian, Harold Szerlip, Aparna Tamirisa, Stephen Thomson, Tuan-Huy Tran, Richard Treger, Gretel Trullenque, Thomas Turk, Guillermo Umpierrez, Daniel Urbach, Martin Valdes, Shujauddin Valika, Damaris Vega, Peter Weissman, Adam Whaley-Connell, Jonathan Winston, Jonathan Wise, Alan Wynne, Steven Zeig, Phuong Chu, Lam Van Hoang, Tran Khanh, Nguyen Thi Phi Nga, Pham Nguyen Son, Lan Phuong Tran
Journal: Diabetes Care (2022)

Finerenone significantly improved cardiorenal outcomes in patients with chronic kidney disease (CKD) and type 2 diabetes (T2D) in the Finerenone in Reducing Kidney Failure and Disease Progression in Diabetic Kidney Disease trial. We explored whether baseline HbA1c level and insulin treatment influenced outcomes.Patients with T2D, urine albumin-to-creatinine ratio (UACR) of 30-5,000 mg/g, estimated glomerular filtration rate (eGFR) of 25 to <75 mL/min/1.73 m2, and treated with optimized renin-angiotensin system blockade were randomly assigned to receive finerenone or placebo. Efficacy outcomes included kidney (kidney failure, sustained decrease ≥40% in eGFR from baseline, or renal death) and cardiovascular (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) composite endpoints. Patients were analyzed by baseline insulin use and by baseline HbA1c <7.5% (58 mmol/mol) or ≥7.5%.Of 5,674 patients, 3,637 (64.1%) received insulin at baseline. Overall, 5,663 patients were included in the analysis for HbA1c; 2,794 (49.3%) had baseline HbA1c <7.5% (58 mmol/mol). Finerenone significantly reduced risk of the kidney composite outcome independent of baseline HbA1c level and insulin use (Pinteraction = 0.41 and 0.56, respectively). Cardiovascular composite outcome incidence was reduced with finerenone irrespective of baseline HbA1c level and insulin use (Pinteraction = 0.70 and 0.33, respectively). Although baseline HbA1c level did not affect kidney event risk, cardiovascular risk increased with higher HbA1c level. UACR reduction was consistent across subgroups. Adverse events were similar between groups regardless of baseline HbA1c level and insulin use; few finerenone-treated patients discontinued treatment because of hyperkalemia.Finerenone reduces kidney and cardiovascular outcome risk in patients with CKD and T2D, and risks appear consistent irrespective of HbA1c levels or insulin use.