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Finerenone in Hispanic Patients With CKD and Type 2 Diabetes: A Post Hoc FIDELITY Analysis
Sylvia E Rosas1, Luis M Ruilope2, Stefan D Anker3,4
1Kidney and Hypertension Unit, Joslin Diabetes Center and Harvard Medical School, Boston, MA.
Kidney Medicine
|September 25, 2023
Summary
Finerenone demonstrated similar efficacy and safety in Hispanic patients with chronic kidney disease and type 2 diabetes compared to non-Hispanic patients. This treatment offers comparable cardiorenal benefits across diverse populations.
Area of Science:
- Nephrology and Endocrinology
- Cardiovascular Medicine
- Clinical Trial Analysis
Background:
- Chronic kidney disease (CKD) and type 2 diabetes (T2D) disproportionately affect Hispanic populations, often with more aggressive progression.
- Finerenone has shown cardiorenal benefits in T2D patients with CKD, but data in specific ethnic groups, like Hispanics, are less robust.
- Understanding treatment efficacy and safety in diverse populations is crucial for equitable healthcare.
Purpose of the Study:
- To evaluate the efficacy and safety of finerenone in Hispanic patients with CKD and T2D.
- To compare cardiorenal outcomes and urinary albumin-to-creatinine ratio (UACR) changes between Hispanic and non-Hispanic patient subgroups.
- To assess the consistency of finerenone's benefits across different ethnic groups.
Main Methods:
- Post hoc analysis of the FIDELITY pooled data from the FIDELIO-DKD and FIGARO-DKD randomized controlled trials.
- Included patients with T2D and CKD receiving optimized renin-angiotensin system blockade.
- Assessed cardiovascular composite outcomes, kidney composite outcomes, and UACR changes, comparing finerenone to placebo in Hispanic and non-Hispanic groups.
Main Results:
- Finerenone showed consistent cardiovascular benefit in Hispanic patients (HR, 0.80; 95% CI, 0.62-1.04) compared to placebo, similar to non-Hispanic patients (HR, 0.87; 95% CI, 0.79-0.97).
- Kidney composite outcomes were also comparable between Hispanic (HR, 0.94; 95% CI, 0.67-1.33) and non-Hispanic patients (HR, 0.75; 95% CI, 0.64-0.87).
- Finerenone significantly reduced UACR by 32% in Hispanic patients, mirroring effects in non-Hispanic groups. Safety profiles, including hyperkalemia, were similar across groups.
Conclusions:
- Finerenone demonstrates similar efficacy in improving cardiorenal outcomes and reducing UACR in Hispanic patients with CKD and T2D as observed in non-Hispanic patients.
- The safety profile of finerenone is consistent across Hispanic and non-Hispanic populations.
- These findings support the use of finerenone as a therapeutic option for Hispanic patients with CKD and T2D.
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