Finerenone and Left Ventricular Hypertrophy in Chronic Kidney Disease and Type 2 Diabetes
Authors' conclusion
In conclusion, the overall CV and kidney benefits of finerenone versus placebo were not modified by the presence of LVH at baseline, with overall safety findings being similar between LVH subgroups.
Study context
- Population
- Patients with chronic kidney disease (CKD) and T2DM, stratified by investigator-reported electrocardiogram (ECG) diagnosis of left ventricular hypertrophy (LVH) at baseline9.6% with LVH
- Participants
- 13,026 patients
- Comparison
- Finerenone vs placebo, by baseline LVH
- Primary endpoint
- Composite CV outcome (CV death, non-fatal MI, non-fatal stroke or HF hospitalization) and composite kidney outcome (kidney failure, sustained estimated glomerular filtration rate (eGFR) decrease ≥57% over ≥4 weeks, or kidney-related death), by baseline LVH
Methodological detailsrandomized, double-blind, placebo-controlled, multicentre, phase III
- Randomized
- Double-blind
- Placebo-controlled
- Multicentre
- Phase III
Primary result
As reported in the abstract
Composite CV and kidney outcomes, LVH vs no LVH
- Relative risk reduction with finerenone vs placebo lower in LVH subgroup; treatment effect not modified by baseline LVH (composite cardiovascular (CV) outcome)
- Pinteraction = 0.1075
- Treatment effect not modified by baseline LVH (composite kidney outcome)
- Pinteraction = 0.1782
Further findings
HF hospitalization, LVH vs no LVH
- Greater reduction in hospitalization for heart failure (HHF) risk with finerenone vs placebo in patients with baseline LVH than without
- P for interaction = 0.0024
Safety
Treatment-emergent adverse events
- Overall safety events comparable between LVH subgroups and treatment arms
- Hyperkalaemia more frequent with finerenone vs placebo; discontinuation rates low in both arms and LVH subgroups
Original publication
Finerenone and Left Ventricular Hypertrophy in Chronic Kidney Disease and Type 2 Diabetes. ESC Heart Fail. Published 3 September 2024. doi:10.
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