Kidney Week

Abstract: FR-PO325

Reduction in Urinary Albumin-to-Creatinine Ratio (UACR) in People with CKD and Type 2 Diabetes Initiating Finerenone: A Comedication Subgroup Analysis from the FOUNTAIN Platform

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

• Kovesdy, Csaba P., Division of Nephrology, University of Tennessee, Memphis, Tennessee, United States

Csaba P. Kovesdy, MD, FASN

• Layton, J. Bradley, RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States

J. Bradley Layton, PhD

• Thapa, Bishnu Bahadur, OM1, Inc., Boston, Massachusetts, United States

Bishnu Bahadur Thapa, PhD

• Curhan, Gary C., OM1, Inc., Boston, Massachusetts, United States

Gary C. Curhan, MD, ScD, FASN

• Rangel, Luis Manuel, OM1, Inc., Boston, Massachusetts, United States

Luis Manuel Rangel, MS

• Farjat, Alfredo E., Bayer AG, Berlin, Germany

Alfredo E. Farjat, PhD

• Liu, Fangfang, Bayer AG, Berlin, Germany

Fangfang Liu, PhD

• Johannes, Catherine B., RTI Health Solutions Waltham, Waltham, Massachusetts, United States

Catherine B. Johannes, PhD

• Vizcaya, David, Bayer AG, Berlin, Germany

David Vizcaya, PhD, MPH

• Oberprieler, Nikolaus G., Bayer AG, Berlin, Germany

Nikolaus G. Oberprieler, PhD

Background

Evidence from clinical trials demonstrates that finerenone reduces UACR and the risk of adverse cardiovascular and renal outcomes among people with CKD and T2D. Here we aim to describe the change in UACR across subgroups of users of other medications in people initiating finerenone in clinical practice in the United States.

Methods

This cohort study included people with prior diagnoses of CKD and T2D initiating finerenone between July 2021 and August 2023. Data were obtained from US electronic health records and insurance claims (OM1 Real-World Data Cloud^TM). Median UACR was determined at baseline, 4 and 12 months, and we described relative changes from baseline to 4 and 12 months, respectively, with 95% confidence intervals.

Results

Amongst 15,948 new users of finerenone, co-exposure to comedications was frequent: RASi, (49.4%), SGLT2i, (38.0%), GLP-1 RA, (25.6%). UACR measurements were available for 2,137 (13.4%) people at baseline, with a median UACR (Q1, Q3) of 211 mg/g (56, 750). From baseline the median UACR of the overall population decreased by 39.3% (50.8%-27.8%) and 41.2% (55.1%-27.3%) at 4 and 12 months, respectively. The observed reduction of median UACR from baseline to 4 and 12 months for comedication subgroups are depicted in the figure.

Conclusion

This analysis from the FOUNTAIN platform suggests that median UACR level decreases approximately 40% within 4 months after initiating finerenone in routine clinical practice and that this effect is sustained over 12 months. This reduction appears to be consistent irrespective of co-exposure to RASi, SGLT2i, or GLP-1 RA.

Funding

• Commercial Support – Bayer AG