Abstract: FR-PO324
Utilization of Guideline-Directed Medical Therapies in Finerenone Users
Session Information
- Diabetic Kidney Disease: Clinical Modeling, Diagnosis, Education, and More
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 702 Diabetic Kidney Disease: Clinical
Authors
- Zheng, Zihe, Bayer US, LLC, Whippany, New Jersey, United States
- Fatoba, Samuel T., Bayer US, LLC, Whippany, New Jersey, United States
- Novin, Matthew, Bayer US, LLC, Whippany, New Jersey, United States
- Guerrero, German, Bayer US, LLC, Whippany, New Jersey, United States
- Wang, Yunxun, Bayer US, LLC, Whippany, New Jersey, United States
- Farag, Youssef MK, Bayer US, LLC, Whippany, New Jersey, United States
- Mckee, Connor W., Cobbs Creek Healthcare LLC, Newtown Square, Pennsylvania, United States
- Tian, Hongping, Cobbs Creek Healthcare LLC, Newtown Square, Pennsylvania, United States
- Singh, Rakesh, Bayer US, LLC, Whippany, New Jersey, United States
- Du, Yuxian, Bayer US, LLC, Whippany, New Jersey, United States
- Mares, Jon W., Bayer US, LLC, Whippany, New Jersey, United States
- Rockett, Drew, Bayer US, LLC, Whippany, New Jersey, United States
- Sankaralingam, Karthik, Bayer US, LLC, Whippany, New Jersey, United States
- Huang, Wei, Cobbs Creek Healthcare LLC, Newtown Square, Pennsylvania, United States
- Lavagnino, Marco, Bayer US, LLC, Whippany, New Jersey, United States
Background
Non-steroidal MRA finerenone reduces CV risk and slows CKD progression in patients with CKD and T2D. Clinical guidelines recommend finerenone for patients with UACR > 30mg/g despite maximum tolerated RAS inhibitor (ACEi/ARB). However, it is reported that 30-50% of patients with CKD and T2D do not receive ACEi/ARBs, and about 30% of those discontinue within 6 months, contributing to the inertia for new disease-modifying therapies. To address this inertia, we assess the key characteristics of finerenone users in real-world setting with and without concomitant ACEi/ARB.
Methods
We conducted a retrospective study of finerenone users from July 2021 to December 2023 using the IQVIA Longitudinal Access and Adjudication Data. Adult patients with ≥ 12 months of continuous activity prior to their first filled finerenone claim date (index) were included. Patient demographics, comorbidities, and comedications stratified by ACEi/ARB status were described.
Results
The largest finerenone user cohort of 107,323 patients were included, among them 49,864 (46.5%) initiated finerenone in the absence of concomitant ACEi/ARB therapy. Patient age, gender, and key comorbidities were largely comparable, except for that finerenone users without ACEi/ARB had slightly higher prevalence of HF (22%) compared to those with ACEi/ARB (16%). Comedications use were 3-10% less common in the finerenone user without ACEi/ARB group, including SGLT2is and GLP1RAs. Interestingly, 5,077 (4.7%) finerenone users initiated SGLT2i after starting finerenone.
Conclusion
Our study shows that 46.5% patients initiated finerenone without concomitant ACEi/ARB. Finerenone use in the absence of ACEi/ARBs is common in routine clinical practice, suggesting that despite guideline recommendations, therapies are used in a variety of sequences and combinations to accommodate patient profiles. Future study should examine CV, kidney, and safety outcomes of finerenone users with and without ACEi/ARB.
Funding
- Commercial Support – Bayer US LLC