Combining Empagliflozin and Finerenone in Patients with Diabetes and Albuminuria

To delay progression of diabetic kidney disease, guidelines recommend 3 drug classes for selected patients: (1) renin–angiotensin system inhibitors, (2) sodium–glucose cotransporter-2 (SGLT-2) inhibitors, and (3) the nonsteroidal mineralocorticoid-receptor antagonist finerenone (Kidney Int 2024; 105:684). However, data on simultaneous use of all 3 agents are limited. To examine short-term effects of these drugs in combination, researchers conducted a placebo-controlled, randomized trial, funded by finerenone's manufacturer.

The trial included 800 patients with type 2 diabetes, current treatment with renin–angiotensin system inhibitors, estimated glomerular filtration rate between 30 and 90 mL/minute/1.73 m² (mean, 54 mL/minute), and albuminu…