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Kidney Week

Abstract: FR-PO326

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

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Kovesdy, Csaba P., Division of Nephrology, University of Tennessee, Memphis, Tennessee, United States
  • Layton, J. Bradley, RTI Health Solutions Research Triangle Park, Research Triangle Park, North Carolina, United States
  • Thapa, Bishnu Bahadur, OM1, Inc., Boston, Massachusetts, United States
  • Rangel, Luis Manuel, OM1, Inc., Boston, Massachusetts, United States
  • Curhan, Gary C., OM1, Inc., Boston, Massachusetts, United States
  • Farjat, Alfredo E., Bayer AG, Berlin, Germany
  • Liu, Fangfang, Bayer AG, Berlin, Germany
  • Johannes, Catherine B., RTI Health Solutions Waltham, Waltham, Massachusetts, United States
  • Vizcaya, David, Bayer AG, Berlin, Germany
  • Oberprieler, Nikolaus G., Bayer AG, Berlin, Germany
Background

Evidence from clinical trials shows that finerenone reduces UACR and the risk of adverse cardiovascular and renal outcomes among people with CKD and T2D. We aim to describe the change in UACR across subgroups of CKD and albuminuria stages in people initiating finerenone in clinical practice in the US.

Methods

This cohort study included people with prior diagnoses of CKD and T2D initiating finerenone between July 2021 and August of 2023. Data were obtained from US electronic health records and insurance claims (OM1 Real-World Data CloudTM). 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% CIs.

Results

Amongst 15,948 new users of finerenone, 3,604 (22.6%) had both a routine UACR and eGFR measurement in the 365 days before initiating finerenone. The proportion of people in the respective CKD stages and albuminuria categories is shown in Figure 1. For the UACR change analysis, routine 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, 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 UACR from baseline to 4 and 12 months by eGFR and albuminuria are depicted in the figure 2.

Conclusion

These results suggest that in clinical practice finerenone is used irrespective of CKD stage and albuminuria category. UACR decreases within 4 months after initiating finerenone and this effect is sustained over 12 months. UACR reduction appears to be consistent, albeit with some variation across CKD stages.

Funding

  • Commercial Support – Bayer AG