Efficacy and safety of finerenone in chronic kidney disease associated with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials

source extracted confidence: high 2026-04-09
#humans #diabetes-mellitus-type-2 #randomized-controlled-trials-as-topic #renal-insufficiency-chronic #naphthyridines

Efficacy and safety of finerenone in chronic kidney disease associated with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials

Bao et al., 2022 | Eur J Clin Pharmacol | Meta Analysis

Citation

Bao Wujisiguleng, Zhang Mingzhu, ... Sun Luying. Efficacy and safety of finerenone in chronic kidney disease associated with type 2 diabetes: a systematic review and meta-analysis of randomized clinical trials. Eur J Clin Pharmacol. 2022-Dec;78(12):1877-1887. doi:10.1007/s00228-022-03408-w

Abstract

PURPOSE: The main objective was to evaluate the clinical efficacy and safety of finerenone in patients with CKD associated with T2D, especially with regard to renal and cardiovascular protection. METHODS: Eight databases were searched. Mean difference (MD) with 95% confidence interval (CI) of the outcomes and risk ratio (RR) were calculated as the effect measure. RESULTS: Four trials (n = 13,510) were included. Compared to placebo groups, the urinary albumin-to-creatinine ratio (UACR) mean ratio, along with the proportion of patients with a decreased eGFR (≥ 40%) and end-stage kidney disease (ESKD), was significantly lower (MD: -0.30 (95% CI: -0.32, -0.28), p < 0.00001; RR: 0.85 (95% CI: 0.78, 0.93), p = 0.0002; RR: 0.80 (95% CI: 0.65, 0.99), p = 0.04, respectively). Furthermore, the proportion of patients with cardiovascular events (CVs) was significantly lower (RR: 0.88 (95% CI: 0.80, 0.96), p = 0.003). In terms of safety, while the increase in serum potassium concentration and the incidence of hyperkalemia were significantly higher in the finerenone groups (MD: 0.16 (95% CI: 0.07, 0.26), p = 0.00006; RR: 2.03 (95% CI: 1.83, 2.26), p < 0.00001, respectively), the all-cause mortality and the incidence of adverse events (AEs) were similar to placebo (RR: 0.90 (95% CI: 0.80, 1.00), p = 0.05; RR: 1.00 (95% CI: 0.98, 1.01), p = 0.65, respectively). CONCLUSION: The observed renal and cardiovascular benefits of finerenone were significant and did not cause unacceptable side-effects. Finerenone may represent a promising therapeutic tool for CKD associated with T2D.

Key Findings

Four trials (n = 13,510) were included. Compared to placebo groups, the urinary albumin-to-creatinine ratio (UACR) mean ratio, along with the proportion of patients with a decreased eGFR (≥ 40%) and end-stage kidney disease (ESKD), was significantly lower (MD: -0.30 (95% CI: -0.32, -0.28), p < 0.00001; RR: 0.85 (95% CI: 0.78, 0.93), p = 0.0002; RR: 0.80 (95% CI: 0.65, 0.99), p = 0.04, respectively). Furthermore, the proportion of patients with cardiovascular events (CVs) was significantly lower

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population ckd associated with t2d
Sample Size 13510
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Diabetes Mellitus, Type 2
  • Randomized Controlled Trials as Topic
  • Renal Insufficiency, Chronic
  • Naphthyridines
  • Potassium

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Meta-Analysis, Systematic Review, Journal Article
  • Vertical: potassium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09