A study investigated the combined long-term benefits of using sodium-glucose co-transporter 2 (SGLT2) inhibitors and mineralocorticoid-receptor antagonists (MRA) for patients with type 2 diabetes and chronic kidney disease (CKD). Utilizing data from the CREDENCE and FIDELIO trials for canagliflozin and finerenone respectively, and applying these to a control group from the DAPA-CKD trial, researchers aimed to assess the improvement in event-free and overall survival.

The results demonstrated a marked improvement in event-free survival among those treated with the combination therapy. At age 50, such patients were projected to have 16.7 years free from severe kidney events, in contrast to just 10.0 years for those treated with standard therapies like angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, yielding an added benefit of 6.7 years. Assuming reduced adherence and efficacy, the combination therapy was expected to extend event-free survival by 2.5 years. This evidence supports the substantial benefit of combining an SGLT2 inhibitor and MRA in extending the period free from significant kidney complications in this patient population.

Reference: Heerspink HJL, Vart P, Jongs N, et al. Estimated lifetime benefit of novel pharmacological therapies in patients with type 2 diabetes and chronic kidney disease: A joint analysis of randomized controlled clinical trials. Diabetes Obes Metab. 2023 Nov;25(11):3327-3336. doi: 10.1111/dom.15232. Epub 2023 Aug 14. PMID: 37580309.