Abstract: FR-PO0494
Finerenone in Patients with CKD by SGLT2 Inhibitor Treatment: A FIND-CKD Analysis
Session Information
- CKM: Clinical - Trials, Epidemiology, and Biomarkers
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Cardiovascular-Kidney-Metabolic Health
- 602 Cardiovascular-Kidney-Metabolic Health: Clinical
Authors
- Cherney, David, University Health Network, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
- Agarwal, Rajiv, Richard L. Roudebush VA Medical Center, Indianapolis, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Lam, Carolyn S.P., National Heart Centre Singapore, Singapore, Singapore
- Neuen, Brendon Lange, George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Perkovic, Vlado, University of New South Wales, Sydney, New South Wales, Australia
- Tuttle, Katherine R., Providence Inland Northwest Health, University of Washington School of Medicine, Spokane, Washington, United States
- Sarafidis, Pantelis, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
- Smeijer, Johannes David, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Brinker, Meike Daniela, Bayer AG, Wuppertal, Germany
- Heerspink, Hiddo Jan L., George Institute for Global Health, University of New South Wales, Sydney, Australia
Background
Management of chronic kidney disease (CKD) has evolved to incorporate complementary therapies with synergistic mechanisms, such as the nonsteroidal mineralocorticoid receptor antagonist finerenone and sodium–glucose co-transporter-2 inhibitors (SGLT2is), to reduce kidney and cardiovascular (CV) outcomes in patients with type 2 diabetes (T2D).
Finerenone has been shown to slow kidney disease progression and reduce CV risk in patients with CKD, with and without T2D. This FIND-CKD sub-analysis examines the efficacy and safety of finerenone by baseline SGLT2i use in patients with non-diabetic CKD.
Methods
Patients with CKD (estimated glomerular filtration rate [eGFR], 25 to <90 mL/min/1.73 m2), albuminuria (UACR 200 to ≤3500 mg/g), and on optimized renin–angiotensin system blockade were randomized 1:1 to oral finerenone (10 or 20 mg) or placebo. Efficacy outcomes included the mean annual rate of eGFR change from baseline to month 32, and the time-to-event assessment of a composite kidney-CV outcome (sustained ≥57% eGFR reduction from baseline, kidney failure, heart failure hospitalization or CV death). Safety outcomes were assessed as treatment-emergent adverse events.
Results
FIND-CKD included 1584 patients. Among them, 17% of patients (n=270; 135 per treatment arm) received an SGLT2i at baseline. Finerenone reduced the rate of total eGFR decline (mL/min/1.73 m2/year) with a mean annual rate change of –3.3 (95% confidence interval (CI) –3.6, –3.1) vs placebo (–4.0 [95% CI –4.3, –3.8]) over 32 months (between-group difference: 0.7 [95% CI 0.3, 1.1]; P=0.0003). This effect was similar by baseline SGLT2i use (with SGLT2i: –3.2 [95% CI –3.8, –2.5] with finerenone vs –4.0 [95% CI –4.6, –3.3] with placebo and without SGLT2i: –3.4 [95% CI –3.7, –3.1] with finerenone vs –4.0 [95% CI –4.3, –3.7] with placebo; pinteraction=0.7117). The overall composite kidney–CV outcome was lower with finerenone vs placebo (hazard ratio 0.77; 95% CI 0.60, 0.99) and was also not modified by SGLT2i use (pinteraction=0.5473). Hyperkalemia occurred most frequently with finerenone, but events that led to hospitalization were low.
Conclusion
Finerenone reduced the risks of kidney and CV outcomes in patients with CKD irrespective of SGLT2i use. This FIND-CKD subanalysis has provided insight into the potential benefit of combination therapy in patients with non-diabetic CKD.
Funding
- Commercial Support – Bayer AG