Pharmaceuticals
Safety and Efficacy of Finerenone in Diabetic Kidney Disease: A Single-Center Retrospective Real-World Comparative Study of Dosing and Clinical Decision-Making in Taiwan
By Jui-Ting Hsu, Pei-Chen Tseng, Lung‐Chih Li and 11 others.
Abstract
Background
Finerenone improves cardiorenal outcomes in patients with chronic kidney disease and type 2 diabetes, but its early real-world effect on albuminuria, the relative safety and effectiveness of standard versus reduced-dose regimens, and the clinical factors influencing dose selection remain unclear.
Methods
This single-center retrospective observational study included 100 patients with diabetic kidney disease: 50 received finerenone plus standard care, and 50 contemporaneous controls received standard care alone. Controls met the same eligibility criteria but were not prescribed finerenone because of physician judgment, patient preference, or financial or reimbursement considerations. UACR, serum creatinine, eGFR, and serum potassium were measured at baseline and after a mean of 28 ± 5 days (range, 21–35 days). Standard-dose finerenone was defined as 10 or 20 mg daily; reduced-dose regimens included alternate-day or intermittent weekly schedules. The principal efficacy analysis used adjusted log-transformed UACR to account for baseline imbalance and skewness. Responder, dose-stratified, post-hoc pairwise, and AIC-based model-selection analyses were exploratory.
