In a double-blind trial involving 5734 patients with chronic kidney disease (CKD) and type 2 diabetes, finerenone, a selective mineralocorticoid receptor antagonist, was compared to placebo. The primary outcome, a composite of kidney failure, a significant decrease in estimated glomerular filtration rate (eGFR), or death from renal causes, occurred less frequently in the finerenone group (17.8%) compared to the placebo group (21.1%). Similarly, the key secondary outcome, a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure, was less common in the finerenone group (13.0%) compared to placebo (14.8%). Adverse events were similar between the groups, but hyperkalemia-related discontinuations were higher with finerenone.

Overall, these findings suggest that finerenone treatment in patients with CKD and type 2 diabetes led to reduced risks of CKD progression and cardiovascular events compared to placebo, demonstrating its potential as a therapeutic option in this population.

Reference: Bakris GL, Agarwal R, Anker SD, et al. Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes. N Engl J Med. 2020 Dec 3;383(23):2219-2229. doi: 10.1056/NEJMoa2025845. Epub 2020 Oct 23. PMID: 33264825.