BACKGROUND: Evidence from clinical trials demonstrates that finerenone reduces UACR and the risk of adverse cardiovascular and renal outcomes among people with CKD and T2D. Here we aim to describe the change in UACR across subgroups of users of other medications in people initiating finerenone in clinical practice in the United States.
METHODS: This cohort study included people with prior diagnoses of CKD and T2D initiating finerenone between July 2021 and August 2023. Data were obtained from US electronic health records and insurance claims (OM1 Real-World Data Cloud™). Median UACR was determined at baseline, 4 and 12 months, and we described relative changes from baseline to 4 and 12 months, respectively, with 95% confidence intervals.
RESULTS: Amongst 15,948 new users of finerenone, co-exposure to comedications was frequent: RASi, (49.4%), SGLT2i, (38.0%), GLP-1 RA, (25.6%). UACR measurements were available for 2,137 (13.4%) people at baseline, with a median UACR (01, 03) of 211 mg/g (56, 750). From baseline the median UACR of the overall population decreased by 39.3% (50.8%-27.8%) and 41.2% (55.1%-27.3%) at 4 and 12 months, respectively. The observed reduction of median UACR from baseline to 4 and 12 months for comedication subgroups are depicted in the figure.
CONCLUSION: This analysis from the FOUNTAIN platform suggests that median UACR level decreases approximately 40% within 4 months after initiating finerenone in routine clinical practice and that this effect is sustained over 12 months. This reduction appears to be consistent irrespective of co-exposure to RASi, SGLT2i, or GLP-1 RA.
