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在慢性脏病和2型糖尿病患者中,费内伦与螺旋相比:一个向试验仿真试验
Chung-An Wang1,2, Hsuan-Wen Lai2,3, Jui-Yi Chen4,5
1Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC.
Nature communications
|November 1, 2025
概括
在患有慢性病 (CKD) 和2型糖尿病 (T2D) 的患者中,费内伦显示出心血管事件,事件和死亡率的风险较低,而与螺旋龙相比. 芬也降低了高血症的发生率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 在患有慢性病 (CKD) 和2型糖尿病 (T2D) 的患者中,费内伦与螺旋的比较有效性尚未得到充分证实.
- 这两种药物都向矿物质皮质醇受体,但在选择性和潜在的副作用概况上有所不同.
研究的目的:
- 为了比较费内伦和螺旋乳在患有CKD和T2D的成年人中的实际有效性.
- 评估这些治疗对主要不良心血管事件 (MACE),主要不良脏事件 (MAKE),全因死亡率和高血症的影响.
主要方法:
- 一个目标试验仿真研究,使用来自TriNetX.X的全球真实世界数据.
- 倾向性得分匹配被用来比较2268名患有CKD (eGFR15-60毫升/分钟/1.73米2) 和T2D的成年人,这些成年人发起了finerenone或spironolactone.
- 评估结果的中位数是1.3年的随访时间.
主要成果:
- 与spironolactone相比,费内伦与MACE (aHR,0.74;95%CI,0.58-0.94) 和MAKE (aHR,0.47;95%CI,0.33-0.67) 的风险明显较低.
- 芬也显示出所有原因死亡的风险较低 (aHR,0.31;95% CI,0.21-0.45) 和高血症的发病率降低 (17.2%与26.4%相比;P<0.001).
结论:
- 在患有CKD和T2D的患者中,芬瑞可能与螺旋龙相比,具有更好的心脏和脏保护性益处.
- 这些发现表明,芬可能是降低这种患者群体死亡率和心脏病风险的首选治疗方案.
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