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Beernink, J.M.* ; Heerspink, H.J.L.* ; Birkenfeld, A.L. ; Cherney, D.Z.I.* ; Colhoun, H.M.* ; Groop, P.* ; Ji, L.* ; Mathieu, C.* ; Rosas, S.E.* ; Tuttle, K.R.* ; Skyler, J.S.* ; Amor, A.J.* ; Caramori, M.L.* ; Fiorina, P.* ; Jongs, N.* ; Pagotto, U.* ; Setola, E.* ; Brinker, M.* ; Lawatscheck, R.* ; Russel, J.* ; Schloemer, P.* ; McGill, J.B.* ; Rossing, P.*

Effect of finerenone on albuminuria in type 1 diabetes by baseline HbA1c level and diabetes duration: An exploratory analysis of the FINE-ONE trial.

Diabetes Care 49, 1434-1441 (2026)
Verlagsversion DOI PMC
Free by Publisher
Open Access Green möglich sobald Postprint bei der ZB eingereicht worden ist.
OBJECTIVE To evaluate whether the efficacy and safety of finerenone varied by baseline hemoglobin A(1c) (HbA(1c)) level, a proxy of glycemic control, and diabetes duration in people with type 1 diabetes and chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS Adults with type 1 diabetes, urinary albumin-to-creatinine ratio (UACR) 200 to <5,000 mg/g, and estimated glomerular filtration rate (eGFR) 25 to <90 mL/min/1.73 m(2) were randomly assigned (one to one) to finerenone or placebo. UACR change from baseline over 6 months by baseline HbA(1c) and diabetes duration was analyzed. RESULTS Baseline HbA(1c) was available for 240 of 242 participants; mean (SD) HbA(1c), diabetes duration, and eGFR were 7.6% (1.1%; 60 [12] mmol/mol), 32.0 (14.2) years, and 58.9 (19.2) mL/min/1.73 m(2), respectively. At 6 months, HbA(1c) (95% CI) remained unchanged (finerenone +0.03% [-0.14%, 0.20%]; placebo 0.00% [-0.12%, 0.11%]; between-group difference +0.04% [-0.17%, 0.24%]; P = 0.74). Over 6 months, median UACR decreased from 574.6 to 373.5 mg/g with finerenone and from 506.4 to 475.6 mg/g with placebo, corresponding to a -25% placebo-corrected change (95% CI -35%, -13%; P = 0.0001). Treatment effects were consistent across HbA(1c) tertiles (<7.1%, >= 7.1% to <= 8.1%, and >8.1%), with placebo-corrected UACR changes (95% CIs) of -17% (-40%, 13%), -18% (-39%, 10%), and -37% (-55%, -13%), respectively (P interaction = 0.41). Effects were similarly consistent across diabetes duration tertiles (P interaction = 0.70). Overall safety and incidence of hyperkalemia were similar across HbA(1c) tertiles. CONCLUSIONS In adults with type 1 diabetes and CKD, finerenone reduced UACR and was well tolerated irrespective of HbA(1c) level or diabetes duration.
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Publikationstyp Artikel: Journalartikel
Dokumenttyp Wissenschaftlicher Artikel
Schlagwörter Kidney-disease; Excess Mortality; Nationwide; Microalbuminuria
ISSN (print) / ISBN 0149-5992
e-ISSN 1935-5548
Zeitschrift Diabetes Care
Quellenangaben Band: 49, Heft: 8, Seiten: 1434-1441 Artikelnummer: , Supplement: ,
Verlag American Diabetes Association
Verlagsort Alexandria, Va.
Begutachtungsstatus Peer reviewed
Institut(e) Institute for Diabetes Research and Metabolic Diseases (IDM)
Förderungen Bayer AG