BACKGROUND: Both finerenone and sodium-glucose cotransporter 2 inhibitors (SGLT-2Is) improve kidney outcomes in people with type 2 diabetes (T2D) and chronic kidney disease (CKD), but the real-world effectiveness of their combination remains unclear. METHODS: This retrospective, single-center study recruited people with T2D-CKD receiving finerenone on SGLT-2Is or SGLT-2Is alone in West China Hospital of Sichuan University. Kidney outcomes were compared after 1:4 propensity score matching. The primary outcome was the time from drug initiation to ≥ 30% decline in eGFR. The secondary outcome was the change in chronic eGFR slope. RESULTS: /year; 95% CI: -11.81 to -0.75). CONCLUSION: Finerenone added to SGLT-2Is was associated with slower eGFR decline in most individuals with T2D-CKD. However, people with rapid pre-treatment eGFR decline may experience accelerated deterioration when finerenone is added. These findings are hypothesis-generating rather than confirmatory, requiring further well-designed and prospective studies for validation.
Yang et al. (Sun,) studied this question.