Rossing , PeterAnker , Stefan D.Filippatos , GerasimosPitt, BertramRuilope, Luis M.Birkenfeld, Andreas L.McGill, Janet B.Rosas, Sylvia E.Joseph, AmerGebel, MartinRoberts, LukeScheerer, Markus F.Bakris, George L.Agarwal, RajivFIDELIO-DKD InvestigatorsFIGARO-DKD Investigators2024-05-092024-05-092022-12Rossing, P., Anker, S. D., Filippatos, G., Pitt, B., Ruilope, L. M., Birkenfeld, A. L., McGill, J. B., Rosas, S. E., Joseph, A., Gebel, M., Roberts, L., Scheerer, M. F., Bakris, G. L., Agarwal, R., & on behalf of the FIDELIO-DKD and FIGARO-DKD Investigators. (2022). Finerenone in Patients With Chronic Kidney Disease and Type 2 Diabetes by Sodium–Glucose Cotransporter 2 Inhibitor Treatment: The FIDELITY Analysis. Diabetes Care, 45(12), 2991–2998. https://doi.org/10.2337/dc22-0294https://hdl.handle.net/1805/40617OBJECTIVE Finerenone reduced the risk of kidney and cardiovascular events in people with chronic kidney disease (CKD) and type 2 diabetes in the FIDELIO-DKD and FIGARO-DKD phase 3 studies. Effects of finerenone on outcomes in patients taking sodium–glucose cotransporter 2 inhibitors (SGLT2is) were evaluated in a prespecified pooled analysis of these studies. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes and urine albumin-to-creatinine ratio (UACR) ≥30 to ≤5,000 mg/g and estimated glomerular filtration rate (eGFR) ≥25 mL/min/1.73 m2 were randomly assigned to finerenone or placebo; SGLT2is were permitted at any time. Outcomes included cardiovascular composite (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) and kidney composite (kidney failure, sustained ≥57% eGFR decline, or renal death) end points, changes in UACR and eGFR, and safety outcomes. RESULTS Among 13,026 patients, 877 (6.7%) received an SGLT2i at baseline and 1,113 (8.5%) initiated one during the trial. For the cardiovascular composite, the hazard ratios (HRs) were 0.87 (95% CI 0.79–0.96) without SGLT2i and 0.67 (95% CI 0.42–1.07) with SGLT2i. For the kidney composite, the HRs were 0.80 (95% CI 0.69–0.92) without SGLT2i and 0.42 (95% CI 0.16–1.08) with SGLT2i. Baseline SGLT2i use did not affect risk reduction for the cardiovascular or kidney composites with finerenone (Pinteraction = 0.46 and 0.29, respectively); neither did SGLT2i use concomitant with study treatment. CONCLUSIONS Benefits of finerenone compared with placebo on cardiorenal outcomes in patients with CKD and type 2 diabetes were observed irrespective of SGLT2i use.en-USPublisher PolicyDiabetesFirerenoneCardiovascular eventsChronic Kidney DiseaseSodium–glucose cotransporter 2 inhibitors (SGLT2is)Article