Integrated Evidence Generation. Bayer Pharmaceuticals, Sant Joan Despí, 08970, Spain.
Division of Nephrology, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
J Comp Eff Res. 2023 Aug;12(8):e230076. doi: 10.57264/cer-2023-0076. Epub 2023 Jun 30.
Finerenone is safe and efficacious for treating patients with chronic kidney disease (CKD) and Type 2 diabetes (T2D). Evidence on the use of finerenone in clinical practice is lacking. To describe demographic and clinical characteristics of early adopters of finerenone in the United States, according to sodium-glucose cotransporter 2 inhibitor (SGLT2i) use and urine albumin-creatinine ratio (UACR) levels. Multi-database, observational, cross-sectional study, using data from two US databases (Optum Claims and Optum EHR). Three cohorts were included: finerenone initiators with prior CKD-T2D, finerenone initiators with prior CKD-T2D and concomitant SGLT2i use, finerenone initiators with prior CKD-T2D stratified according to UACR. In total, 1015 patients were included, 353 from Optum Claims and 662 from Optum EHR. Mean age was 72.0 and 68.4 years in Optum claims and EHR, respectively. Median eGFR was 44 and 44 ml/min/1.73 m; and median UACR was 132 (28-698)/365 (74-1185.4) mg/g, in Optum Claims and EHR, respectively. 70.5/70.4% were taking renin-angiotensin system inhibitors, 42.5/53.3% SGLT2i. Overall, 9.0/6.3% of patients had baseline UACR <30 mg/g, 15.0/20.2% had UACR 30-300 mg/g, and 14.4/27.6% had UACR >300 mg/g. Current management of patients with CKD-T2D reflects use of finerenone independently from background therapies and clinical characteristics, suggesting implementation of therapeutic strategies based on different modes of action.
非奈利酮治疗慢性肾脏病（CKD）合并 2 型糖尿病（T2D）患者安全且有效。目前临床实践中应用非奈利酮的相关证据较少。本研究旨在根据钠-葡萄糖共转运蛋白 2 抑制剂（SGLT2i）的使用情况和尿白蛋白/肌酐比值（UACR）水平，描述美国非奈利酮早期使用者的人口统计学和临床特征。这是一项多数据库、观察性、横断面研究，使用了来自美国两个数据库（Optum Claims 和 Optum EHR）的数据。共纳入了 3 个队列：既往有 CKD-T2D 的非奈利酮初治患者、既往有 CKD-T2D 且同时使用 SGLT2i 的非奈利酮初治患者、根据 UACR 分层的既往有 CKD-T2D 的非奈利酮初治患者。共纳入 1015 例患者，其中 353 例来自 Optum Claims，662 例来自 Optum EHR。Optum Claims 和 EHR 中的患者平均年龄分别为 72.0 岁和 68.4 岁。中位 eGFR 分别为 44 和 44 ml/min/1.73 m；Optum Claims 和 EHR 中的患者中位 UACR 分别为 132（28-698）/365（74-1185.4）mg/g。分别有 70.5%/70.4%的患者正在服用肾素-血管紧张素系统抑制剂，42.5%/53.3%的患者正在服用 SGLT2i。总体而言，9.0%/6.3%的患者基线 UACR <30mg/g，15.0%/20.2%的患者 UACR 为 30-300mg/g，14.4%/27.6%的患者 UACR >300mg/g。CKD-T2D 患者的当前治疗方法反映了非奈利酮的使用独立于背景治疗和临床特征，这表明基于不同作用模式实施了治疗策略。
