Oberprieler NG, Kovesdy CP, Layton JB, Gay A, Farjat AE, Liu F, Johannes CB, Pladevall-Vila M, Vizcaya D. Early use and effectiveness of finerenone in US patients with CKD and type 2 diabetes: a FOUNTAIN platform analysis. Poster presented at the Kidney Week 2023; November 2, 2023. Philadelphia, PA.

BACKGROUND: Based on evidence from clinical trials, finerenone reduces the risk of cardiovascular and renal complications among patients with chronic kidney disease (CKD) and type 2 diabetes (T2D). Evidence from finerenone use in real-world clinical practice is lacking.

METHODS: Longitudinal (from July 2021 to latest data available) cohort study using two existing US electronic health record and insurance claim databases (Optum EHR and OM1 Real-World Data CloudTM). Among individuals with both CKD and T2D, a single cohort of new users of finerenone is described (patient characteristics, comorbidities, comedications, and incidence rates of cardiovascular and renal outcomes, including eGFR and UACR changes over time).

RESULTS: Preliminarily, results from an initial feasibility assessment show a total of 662 new users of finerenone (Optum EHR only) who had a mean (SD) age of 72.1 (8.3) years with 46.6% being female. The most common comorbidities at baseline were hypertension (98.3%), hyperlipidemia (87.5%), peripheral vascular disease (66.8%), neuropathy (53.7%), retinopathy (35.5%), and congestive heart failure (34.4%); 9.9% of individuals had acute coronary syndrome and 6.5% experienced a stroke prior to finerenone initiation. Baseline comedication use was common with 70.5% of individuals using an angiotensin-converting enzyme inhibitor (ACE) or an angiotensin receptor blocker (ARB), 60.2% a beta-blocker, and 50.6% calcium channel blockers (CCB). Furthermore, 90.9% of finerenone users used anti-hyperglycemic medication as monotherapy or in multi-drug combinations, including insulins (46.6%), metformin (42.9%), sodium-glucose cotransporter-2 (SGLT2) inhibitors (42.3%), and glucagon-like peptide-1 (GLP-1) receptor agonists (35.2%). Complete results from the full Optum EHR and OM1 Real-World Data CloudTM databases, including incidence rates of cardiovascular and renal outcomes, will be presented as part of the conference presentation.

CONCLUSION: Early evidence from patients who receive finerenone as part of clinical practice in the USA suggests that finerenone is used independently of demographic and clinical characteristics. Furthermore, this analysis of early adopters suggests that finerenone is used as a complementary treatment option to other renal and cardiovascular protective medication-classes recommended for patients with CKD and T2D.

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